Individual provider Active NPI

Pratima Boinepalli, M.D.

  • Pediatrics Physician
  • Okemos, MI
National Provider Identifier
1073794764
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301085879 Issued in MI
Practice address
3945 Okemos Rd Ste A1
Okemos, MI 48864-4207
Phone
(517) 295-5000
Fax
(517) 507-5424
NPI assigned
Nov 21, 2007
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301085879 MI Primary

Addresses

Primary practice location

3945 Okemos Rd Ste A1
Okemos, MI 48864-4207

Mailing address

3945 Okemos Rd Ste A1
Okemos, MI 48864-4207
Phone (517) 295-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pratima Boinepalli MD, P.L.L.C Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1073794764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3945 OKEMOS RD STE A1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488644207",
            "telephone_number": "517-295-5000",
            "fax_number": "517-507-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 OKEMOS RD STE A1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488644207",
            "telephone_number": "517-295-5000",
            "fax_number": "517-507-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOINEPALLI",
        "first_name": "PRATIMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301085879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.