NPIMap

Individual provider Active NPI

Srikanth Reddy Boddu, M.S; MRCS; FRCR; MD

  • Vascular & Interventional Radiology Physician
  • Flushing, NY
National Provider Identifier
1225393416
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
274778 Issued in NY
Practice address
5645 Main St
Flushing, NY 11355-5045
Phone
(718) 303-3739
NPI assigned
Jul 12, 2012
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 274778 NY Primary

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355-5045

Mailing address

1305 York Ave
New York, NY 10021-5663
Phone (646) 962-3387

Other practice location 1

525 E 68th St
New York, NY 10065-4870
Phone (212) 746-2821

Other practice location 2

6134 188th St Fl 2
Fresh Meadows, NY 11365-2719
Phone (718) 303-0373

Other practice location 3

11205 Queens Blvd Ste B
Forest Hills, NY 11375-8311
Phone (718) 303-3739

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address srb9017@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170808001574 NY Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8921242736 Reassigns benefits to 4 organizations
I20231127002967 NJ Practitioner - Diagnostic Radiology 8921242736 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Radiology Group LLCGroup PAC ID 6608868500, 239 clinicians
Jersey Shore Imaging LLCGroup PAC ID 1355408212, 148 clinicians
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

1043 W Main St
Freehold, NJ 07728-2538
Phone (732) 462-1900

2100 Corlies Ave
Neptune, NJ 07753-6102
Phone (732) 988-1234

435 E 70TH St
Apt 33D
New York, NY 10021-5351
Phone (732) 390-0040

483 Cranbury Rd
East Brunswick, NJ 08816-3610
Phone 73239000402022

525 E 68TH St
New York, NY 10065-4870
Phone (646) 962-3376

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.47 of 100Reported as group
Quality
84.67
Promoting interoperability
100
Improvement activities
40
Cost
71.47

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.93 of 100Reported as group
Quality
95.96
Improvement activities
40
Cost
73.85

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274778NYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 5, 2017 Accepting new patients
Kings Physician Services, PC Vascular & Interventional Radiology CurrentSince Sep 2, 2020 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2017 Accepting new patients
University Radiology Group, LLC CurrentSince Nov 1, 2023 Accepting new patients
Weill Medical College of Cornell Vascular & Interventional Radiology CurrentSince Jul 1, 2017 Accepting new patients
Kings Physician Services, PC CurrentSince Sep 2, 2020 Accepting new patients
University Radiology at Trinitas, LLC CurrentSince Nov 1, 2023 Accepting new patients
University Radiology-Atlantic, LLC CurrentSince Nov 1, 2023 Accepting new patients
Jersey Shore Imaging, LLC CurrentSince Nov 1, 2023 Accepting new patients
University Radiology at Cooper, LLC CurrentSince Nov 1, 2023 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 5, 2017 Accepting new patients
Hillsborough Radiology Centers, LLC Current Accepting new patients
Jersey Shore Radiology Associates, P.a. Past Accepting new patients
Weill Cornell University Medical College Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Newyork-Presbyterian-Queens Past Accepting new patients

Locations

2339 Route 70 W
Cherry Hill, NJ 08002
Phone (856) 406-4080

483 Cranbury Rd
East Brunswick, NJ 08816
Phone (732) 390-0030

579A Cranbury Rd
East Brunswick, NJ 08816
Phone (732) 390-0030

415 Morris Ave
Elizabeth, NJ 07208
Phone (908) 351-7600

1043 W Main St
Freehold, NJ 07728
Phone (732) 462-1900

111 Union Valley Rd
Monroe Twp, NJ 08831
Phone (609) 395-3470

400 W Route 38
Ste 2300
Moorestown, NJ 08057

3822 River Rd
Point Pleasant Boro, NJ 08742
Phone (732) 701-4848

48 N Gilbert St
Tinton Falls, NJ 07701
Phone (732) 530-5750

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

11205 Queens Blvd
Ste B
Forest Hills, NY 11375
Phone (281) 863-9500

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

6134 188th St
Fl 2
Fresh Meadows, NY 11365
Phone (718) 303-0373

1305 York Ave
New York, NY 10021
Phone (646) 962-2020

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

520 E 70th St
#651
New York, NY 10021
Phone (212) 746-2385

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1225393416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "646-962-3387",
            "fax_number": "646-962-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-303-3739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E 68th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "212-746-2821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6134 188th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Fresh Meadows",
            "state": "NY",
            "postal_code": "113652719",
            "country_code": "US",
            "telephone_number": "718-303-0373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11205 Queens Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113758311",
            "country_code": "US",
            "telephone_number": "718-303-3739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODDU",
        "first_name": "SRIKANTH",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "M.S; MRCS; FRCR; MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "274778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "525 E 68th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "525 E 68th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srb9017@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "525 E 68th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.