Individual provider Active NPI

Ujjwala Seetha Bhagavatula, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Springfield, MA
National Provider Identifier
1336592369
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
284294 Issued in MA
Practice address
101 Wason Ave
Springfield, MA 01107-1140
Phone
(413) 272-6178
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 284294 MA Primary

Addresses

Primary practice location

101 Wason Ave
Springfield, MA 01107-1140

Mailing address

101 Wason Ave
Springfield, MA 01107-1140
Phone (413) 272-6178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250114002907 DC Practitioner - Geriatric Medicine 9436417763 Reassigns benefits to 1 organization
I20250430000420 OH Practitioner - Internal Medicine 9436417763 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284294MAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jan 6, 2025 Accepting new patients
Medstar Medical Group II LLC Internal Medicine CurrentSince Jan 6, 2025 Accepting new patients
Remo Medical Group PA CurrentSince Feb 17, 2025 Accepting new patients
Brooke Grove Foundation, Inc. Past Accepting new patients
Remo Medical Group of California PC Geriatric Medicine PastSince Feb 17, 2025 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

3007 Tilden St NW
Ste 5N
Washington, DC 20008

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

7055 Engle Rd
Middleburg Heights, OH 44130

22722 29th Dr SE
Ste 100
Bothell, WA 98021
Phone (425) 312-2512

1908 Thomes Ave
Ste 12124
Cheyenne, WY 82001

1908 Thomes Ave
Ste 12123
Cheyenne, WY 82001

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1336592369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WASON AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071140",
            "telephone_number": "413-272-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WASON AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071140",
            "telephone_number": "413-272-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAGAVATULA",
        "first_name": "UJJWALA SEETHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "284294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.