NPIMap

Individual provider Active NPI

Lakshmi Bhaskar Biradavolu, M.D.

  • Pediatrics Physician
  • Elmira, NY
National Provider Identifier
1275630980
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
194995 Issued in NY
Practice address
200 Madison Ave
Suite 2B
Elmira, NY 14901-3218
Phone
(607) 732-1310
Fax
(607) 733-0940
NPI assigned
Sep 17, 2006
Last updated
Jan 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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 194995 NY Primary

Addresses

Primary practice location

200 Madison Ave
Suite 2B
Elmira, NY 14901-3218

Mailing address

722 W Water St
Elmira, NY 14905-2435
Phone (607) 271-2050

Other identifiers 1

IdentifierTypeStateIssuer
01648219MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
194995NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Housestaff Past Accepting new patients
Arnot Ogden Medical Center Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Quarry Road Emergency Services P.C. Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1275630980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052435",
            "telephone_number": "607-271-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MADISON AVE",
            "address_2": "SUITE 2B",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013218",
            "telephone_number": "607-732-1310",
            "fax_number": "607-733-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRADAVOLU",
        "first_name": "LAKSHMI",
        "middle_name": "BHASKAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "194995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01648219",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.