Boppana Primary Care Clinic, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BOPPANA PRIMARY CARE CLINIC, PLLC

Practice address

2460 N Central Expy
Suite 101
Richardson, TX 75080-2713

Phone

(972) 644-1100

Fax

(972) 644-1107

NPI assigned

Mar 29, 2007

Last updated

Nov 5, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sita M Boppana, M.D.NPI 1689629123

Title

President

Phone

(972) 644-1100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sita M Boppana, M.D.

  • Internal Medicine Physician
  • Richardson, TX
  • NPI 1689629123
  Medicare reassignment NPD Authorized official
• Manoj Donthineni, M.D.

  • Internal Medicine Physician
  • Garland, TX
  • NPI 1497708093
  NPD (past)
• Sirisha Donepudi, M.D

  • Endocrinology, Diabetes & Metabolism Physician
  • Marion, OH
  • NPI 1023073806

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541376000000",
    "number": "1326168139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830066",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750830066",
            "telephone_number": "972-644-1100",
            "fax_number": "972-644-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N CENTRAL EXPY",
            "address_2": "SUITE 101",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802713",
            "telephone_number": "972-644-1100",
            "fax_number": "972-644-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOPPANA PRIMARY CARE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2018-11-05",
        "status": "A",
        "authorized_official_last_name": "BOPPANA",
        "authorized_official_first_name": "SITA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-644-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151198201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Bollin
• Christy L Bommarito, PHD
• David Gregory Bonnet, M.D.
• Booneville Anesthesia Services LLC
• Patrick Boothe, D.O.
• Sita M Boppana, M.D.
• Latoya Borda, APRN
• James Boren
• Whitney Daine Boren
• Loretta Marie Botel, M.S., LPT

• Internal Medicine Physician in Richardson, TX
• Providers in Richardson, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.