Individual provider Active NPI

Niveditha Popuri, MD

  • Student in an Organized Health Care Education/Training Program
  • Oklahoma City, OK
National Provider Identifier
1336874171
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
39511 Issued in OK
Practice address
800 Stanton L Young Blvd # 6300
Oklahoma City, OK 73104-5018
Phone
(405) 271-5963
NPI assigned
Jul 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 39511 OK Primary

Addresses

Primary practice location

800 Stanton L Young Blvd # 6300
Oklahoma City, OK 73104-5018

Mailing address

800 Stanton L Young Blvd # 6300
Oklahoma City, OK 73104-5018
Phone (405) 271-5963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20220823004017 OK Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7911380944

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39511OKMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of Oklahoma Internal Medicine CurrentSince Jun 9, 2024 Accepting new patients

Locations

800 Stanton L Young Blvd
#6300
Oklahoma City, OK 73104
Phone (405) 271-5963

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": "1658016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1336874171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 STANTON L YOUNG BLVD # 6300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045018",
            "telephone_number": "405-271-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 STANTON L YOUNG BLVD # 6300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045018",
            "telephone_number": "405-271-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPURI",
        "first_name": "NIVEDITHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-17",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "39511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.