Individual provider Active NPI

Sumitra Samidha Golikeri, D.M.D.

  • Pediatric Dentistry
  • Brooklyn, NY
National Provider Identifier
1134315625
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
053625 Issued in NY
Practice address
760 Broadway
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206
Phone
(718) 963-8000
NPI assigned
Sep 19, 2007
Last updated
Jul 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 053625 NY Primary

Addresses

Primary practice location

760 Broadway
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206

Mailing address

760 Broadway Department of Managed Care Room 2B230
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206
Phone (718) 963-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110624000027 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0840478764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

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

Interoperability endpoints

  • Direct secure messaging: sgolikeri562990@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1134315625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY DEPARTMENT OF MANAGED CARE ROOM 2B230",
            "address_2": "WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000",
            "fax_number": "718-630-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLIKERI",
        "first_name": "SUMITRA",
        "middle_name": "SAMIDHA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "053625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.