Kuduvalli Omprakash, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

146561 Issued in NY

Practice address

235 Port Richmond Ave
Staten Island, NY 10302-1701

Phone

(718) 924-2254

Fax

(718) 442-0189

NPI assigned

Mar 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBJJAA

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.

• Community Health Center of Richmond Inc

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
  • NPI 1952739054
  NPD (past)
• Community Health Center of Richmond, Inc

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
  • NPI 1114137403
  NPD (past)
• Staten Island Physician Practice PC

  dba AdvantageCare Physicians

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568413169
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1376504019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PORT RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021701",
            "telephone_number": "718-924-2254",
            "fax_number": "718-442-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 PORT RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021701",
            "telephone_number": "718-924-2254",
            "fax_number": "718-442-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMPRAKASH",
        "first_name": "KUDUVALLI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "146561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00810206",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Steven Ominelli, LMHC
• Mojisola Omoaldun I, L.P.N
• Rita Omomhenle
• Mayowa O Omotosho, RN
• Abidemi Omoyefa
• Sudha K Omprakash, PA
• Osama E Omran, PT, MS. DPT.
• Ego Onaga Consulting Services, M.S.ED
• Chiamaka Onaga, DO
• Chioma Onaga

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.