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Sushma Surrinder Kapoor

Family Medicine

Allopathic & Osteopathic Physicians

1601 Owen Dr, Fayetteville, NC 28304-3425

PECOS Enrollment

This provider is enrolled in PECOS as SUSHMA KAPOOR.

Based on the most recent information from CMS, provider Sushma Surrinder Kapoor is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1497804421
Provider Type
Individual
Full Name
Kapoor, Sushma Surrinder
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
1/9/2007
Last Updated
2/4/2014

Contact Information

Practice Location

1601 Owen Dr, Fayetteville, NC 28304-3425

(910) 678-0100

(910) 678-0115

Mailing Location

6764 Surrey Rd, Fayetteville, NC 28306-2591

(910) 425-9030

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 28101 South Carolina
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 2010-01846 North Carolina

Provider Identifiers

ID	Description	Issuer
ID 20045671	Description Other	Issuer SELECT HEALTH South Carolina
ID 281019	Description Medicaid	Issuer Unlisted South Carolina
ID 576001334002	Description Other	Issuer BLUE CHOICE South Carolina
ID 576001334002	Description Other	Issuer BLUE CROSS BLUE SHIELD South Carolina
ID 576001334007	Description Other	Issuer CHAMPUS South Carolina

Sushma Surrinder Kapoor

PECOS Enrollment

Profile Details

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