Individual provider Active NPI

Padmavathi Jagarlamudi, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1245422328
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37209 Issued in AZ
Practice address
1276 Fulton Avenue
Fulton Family Health Center
Bronx, NY 10456-3499
Phone
(718) 901-6275
Fax
(718) 901-8589
NPI assigned
Aug 13, 2007
Last updated
May 28, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37209 AZ Primary

Addresses

Primary practice location

1276 Fulton Avenue
Fulton Family Health Center
Bronx, NY 10456-3499

Mailing address

1276 Fulton Avenue
Fulton Family Health Center
Bronx, NY 10456-3499
Phone (718) 901-6275

Other identifiers 2

IdentifierTypeStateIssuer
P00438928OtherAZRAIL ROAD MEDICARE
251796MedicaidAZ

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090603000207 NY Practitioner - Internal Medicine 4284728353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
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)

1265 Franklin Ave
FL 6
Bronx, NY 10456-3501
Phone (718) 177-2120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Apr 3, 2017 Accepting new patients
Bronxcare Health System Internal Medicine Current Accepting new patients
Bronxcare Health System CurrentSince Apr 3, 2017 Accepting new patients
Bronxcare Dr. Martin Luther King Jr. Health Center Past Accepting new patients

Locations

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

1276 Fulton Ave
Rm 208
Bronx, NY 10456
Phone (718) 901-8918

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

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1245422328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVENUE",
            "address_2": "FULTON FAMILY HEALTH CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563499",
            "telephone_number": "718-901-6275",
            "fax_number": "718-901-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVENUE",
            "address_2": "FULTON FAMILY HEALTH CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563499",
            "telephone_number": "718-901-6275",
            "fax_number": "718-901-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGARLAMUDI",
        "first_name": "PADMAVATHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "37209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00438928",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251796",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.