NPIMap

Individual provider Active NPI

Bangalore S Sridhara, MD

  • Specialist
  • Stony Point, NY
National Provider Identifier
1063482636
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
213781 Issued in NY
Practice address
12 Liberty Square Mall
Stony Point, NY 10980-2400
Phone
(845) 942-1001
Fax
(845) 942-1431
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 213781 NY Primary

Addresses

Primary practice location

12 Liberty Square Mall
Stony Point, NY 10980-2400

Mailing address

20 Grand Street, 3Rd FL
Warwick, NY 10990-1035
Phone (845) 942-1001

Other identifiers 16

IdentifierTypeStateIssuer
961385OtherNYMVP/TACONIC IPA
193679OtherNYWELLCARE
213781OtherNYCONNECTICARE
213781OtherNYHIP
700608OtherNYUS FAMILY HEALTH PLAN
2386215OtherNYAETNA HMO
P00114326OtherNYRAILROAD MEDICARE
01943466MedicaidNY
58N891OtherNYEMPIRE BC STONY POINT
N67450OtherNYHEALTHNET
000000045698OtherNYGHI HMO
133693126OtherNYTAX ID #
P1979240OtherNYOXFORD
0181480OtherNYGHI PPO
58N892OtherNYEMPIRE BC WEST NYACK
7998110OtherNYAETNA PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041011000492 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9234198359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

2 Crosfield Ave
West Nyack, NY 10994-2226
Phone (845) 353-5600

Hospital & facility affiliations

  • Good Samaritan Hospital of Suffern Hospital, Suffern, NY, CCN 330158
  • Valley Hospital Hospital, Paramus, NJ, CCN 310012
  • Helen Hayes Hospital Hospital, West Haverstraw, NY, CCN 330405
  • St Anthony Community Hospital Hospital, Warwick, NY, CCN 330205
  • Westchester Medical Center Hospital, Valhalla, NY, CCN 330234

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as apm
Quality
87.82
Promoting interoperability
92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rockland Nuclear Spect Imaging, P.C. Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1063482636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND STREET, 3RD FL",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-942-1001",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LIBERTY SQUARE MALL",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109802400",
            "telephone_number": "845-942-1001",
            "fax_number": "845-942-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIDHARA",
        "first_name": "BANGALORE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "213781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP/TACONIC IPA",
            "identifier": "961385",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "193679",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "213781",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "213781",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US FAMILY HEALTH PLAN",
            "identifier": "700608",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2386215",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00114326",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01943466",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC STONY POINT",
            "identifier": "58N891",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "N67450",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "000000045698",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "133693126",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1979240",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO",
            "identifier": "0181480",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC WEST NYACK",
            "identifier": "58N892",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7998110",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Point, NY

Sources for this page

Verify at the official NPI Registry.