Individual provider Active NPI

Rekha Padubidri, MD

  • Adolescent Medicine (Internal Medicine) Physician
  • Boardman, OH
National Provider Identifier
1194706440
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
35.084828 Issued in OH
Practice address
725 Boardman Canfield Rd
Suite J2
Boardman, OH 44512-4380
Phone
(330) 726-0001
Fax
(330) 726-1828
NPI assigned
Nov 11, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 35.084828 OH Primary

Addresses

Primary practice location

725 Boardman Canfield Rd
Suite J2
Boardman, OH 44512-4380

Mailing address

725 Boardman Canfield Rd
Suite J2
Boardman, OH 44512-4380
Phone (330) 726-0001

Other identifiers 1

IdentifierTypeStateIssuer
25215331MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041108000774 OH Practitioner - HospitalistPractitioner - Family Practice 9436112711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 746-7211

8401 Market St
Youngstown, OH 44512-6725
Phone (330) 729-2229

Hospital & facility affiliations

  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.084828OHMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bhargava Ravi MD, LLC PastSince Jun 12, 2015 Accepting new patients

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 3

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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1194706440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD",
            "address_2": "SUITE J2",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-726-0001",
            "fax_number": "330-726-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD",
            "address_2": "SUITE J2",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-726-0001",
            "fax_number": "330-726-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADUBIDRI",
        "first_name": "REKHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-11",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "OH",
            "license": "35.084828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25215331",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.