Individual provider Active NPI

Asha Tadepalli, OD

  • Optometrist
  • Bronx, NY
National Provider Identifier
1194341081
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009128 Issued in NY
Practice address
1650 Selwyn Avenue, Suite 1C
Bronxcare Health System, Department of Ophthalmology
Bronx, NY 10457
Phone
(718) 960-2041
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV009128 NY Primary

Addresses

Primary practice location

1650 Selwyn Avenue, Suite 1C
Bronxcare Health System, Department of Ophthalmology
Bronx, NY 10457

Mailing address

3019 38TH Street CT
Moline, IL 61265-7863
Phone (309) 236-8084

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
I20210525001289 NY Practitioner - Optometry 1254730278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 992-7669

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV009128NYMDOptometrist
009128NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Current Accepting new patients
Bronxcare Health System CurrentSince May 1, 2021 Accepting new patients
Bronxcare Health System CurrentSince May 1, 2021 Accepting new patients
Bronxcare Health System Past Accepting new patients

Locations

1650 Grand Concourse
Fl 2
Bronx, NY 10457
Phone (718) 518-5060

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

1276 Fulton Ave
Rm 219
Bronx, NY 10456

1650 Selwyn Ave
Apt 1C
Bronx, NY 10457
Phone (718) 518-5300

Organizations & group practices 4

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 1

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": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1194341081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 38TH STREET CT",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657863",
            "telephone_number": "309-236-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 SELWYN AVENUE, SUITE 1C",
            "address_2": "BRONXCARE HEALTH SYSTEM, DEPARTMENT OF OPHTHALMOLOGY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-960-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADEPALLI",
        "first_name": "ASHA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.