Individual provider Active NPI

Sumathi Kotikela, M.D.

  • Obstetrics & Gynecology Physician
  • Patterson, NY
National Provider Identifier
1194932731
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
272654 Issued in NY
Practice address
2891 Route 22
Patterson, NY 12563-2228
Phone
(845) 306-0910
Fax
(845) 306-0911
NPI assigned
May 16, 2007
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 272654 NY Primary

Addresses

Primary practice location

2891 Route 22
Patterson, NY 12563-2228

Mailing address

2891 Route 22
Patterson, NY 12563-2228
Phone (845) 306-0910

Other identifiers 1

IdentifierTypeStateIssuer
03734278MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2016 through Jul 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
272654NYMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1194932731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2891 ROUTE 22",
            "city": "PATTERSON",
            "state": "NY",
            "postal_code": "125632228",
            "telephone_number": "845-306-0910",
            "fax_number": "845-306-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 ROUTE 22",
            "city": "PATTERSON",
            "state": "NY",
            "postal_code": "125632228",
            "telephone_number": "845-306-0910",
            "fax_number": "845-306-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTIKELA",
        "first_name": "SUMATHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "272654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03734278",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patterson, NY

Sources for this page

Verify at the official NPI Registry.