NPIMap

Individual provider Active NPI

Sreenivasa R Patibandla, M.D

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1134209463
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219379 Issued in NY
Practice address
1740 Eastchester Rd
Bronx, NY 10461-2300
Phone
(718) 518-2000
Fax
(718) 518-2676
NPI assigned
Oct 17, 2006
Last updated
Aug 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 219379 NY Primary

Addresses

Primary practice location

1740 Eastchester Rd
Bronx, NY 10461-2300

Mailing address

1740 Eastchester Rd
Bronx, NY 10461-2300
Phone (718) 518-2000

Other identifiers 1

IdentifierTypeStateIssuer
02167513MedicaidNY

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
I20091029000566 NY Practitioner - Internal Medicine 9032256649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calvary Hospital IncGroup PAC ID 9133010382, 50 clinicians

Practice addresses (Care Compare)

1740 Eastchester Rd
Bronx, NY 10461-2300
Phone (718) 518-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Calvary Hospital Inc CurrentSince Apr 20, 2019 Accepting new patients
New York Community Hospital of Brooklyn, Inc. Internal Medicine Past Accepting new patients

Locations

1740 Eastchester Rd
Bronx, NY 10461
Phone (718) 518-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1134209463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612300",
            "telephone_number": "718-518-2000",
            "fax_number": "718-518-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612300",
            "telephone_number": "718-518-2000",
            "fax_number": "718-518-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIBANDLA",
        "first_name": "SREENIVASA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02167513",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.