Individual provider Active NPI

Bidarkote Somanath, MD

  • Pediatrics Physician
  • Waterbury, CT
National Provider Identifier
1235131152
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
037034 Issued in CT
Practice address
140 Grandview Ave
Suite No 206
Waterbury, CT 06708-2505
Phone
(203) 753-6413
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 037034 CT Primary

Addresses

Primary practice location

140 Grandview Ave
Suite No 206
Waterbury, CT 06708-2505

Mailing address

140 Grandview Ave
Suite No 206
Waterbury, CT 06708-2505
Phone (203) 753-6413

Other identifiers 1

IdentifierTypeStateIssuer
001370345MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
037034CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliable Pediatrics LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bsomanath@direct.wtbyhosp.org
  • Direct secure messaging: bidarkote.somanath@glacecentral.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1235131152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GRANDVIEW AVE",
            "address_2": "SUITE NO 206",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082505",
            "telephone_number": "203-753-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GRANDVIEW AVE",
            "address_2": "SUITE NO 206",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082505",
            "telephone_number": "203-753-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMANATH",
        "first_name": "BIDARKOTE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "037034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001370345",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.