Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sudha Subramanyam, MD

Individual provider Family Medicine Physician · NPI 1104481555

Sudha Subramanyam, MD is a Family Practice in Nampa, Idaho. Qualified in 2009, 17 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
17
Licensed in
ID
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9850 W St Lukes Dr
Nampa, ID 83687-7912
Phone: (208) 205-7282
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 215 E Hawaii Ave, Nampa, ID 83686-6011 — (208) 514-2529

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence M15981 (ID)
Family Medicine Physician Taxonomy 207Q00000X · Licence MRM-1815 (ID)

Record details

NPI number1104481555
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 1, 2019
Last updated in NPPESJune 6, 2022
Certification dateJune 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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