Individual provider Active NPI

Radha Putcha, MD

  • Internal Medicine Physician
  • Wilmington, NC
National Provider Identifier
1386645380
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2006- 01189 Issued in NC
Practice address
1414 Physicians Drive
Wilmington, NC 28401-7335
Phone
(910) 796-7900
Fax
(910) 796-7904
NPI assigned
Aug 2, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2006- 01189 NC Primary

Addresses

Primary practice location

1414 Physicians Drive
Wilmington, NC 28401-7335

Mailing address

1414 Physicians Drive
Wilmington, NC 28401-7335
Phone (910) 796-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20061121000189 NC Practitioner - Internal MedicinePractitioner - Other (Physician) 4789682063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1414 Physicians Dr
Wilmington, NC 28401-7335
Phone (910) 796-7900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006- 01189NCMDInternal Medicine Physician

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, 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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1386645380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 PHYSICIANS DRIVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017335",
            "telephone_number": "910-796-7900",
            "fax_number": "910-796-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 PHYSICIANS DRIVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017335",
            "telephone_number": "910-796-7900",
            "fax_number": "910-796-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTCHA",
        "first_name": "RADHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2006- 01189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.