Individual provider Active NPI

Jayasri Bukkapatnam, MD

  • Obstetrics & Gynecology Physician
  • Orlando, FL
National Provider Identifier
1407007115
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME104383 Issued in FL
Practice address
21 W Columbia St
Orlando, FL 32806-1133
Phone
(321) 841-5560
Fax
(407) 425-5947
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME104383 FL Primary

Addresses

Primary practice location

21 W Columbia St
Orlando, FL 32806-1133

Mailing address

21 W Columbia St
Orlando, FL 32806-1133
Phone (321) 841-5560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160125001367 GA Practitioner - Obstetrics/Gynecology 2365583556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Women'S Heathcare Specialists, LLCGroup PAC ID 0345246021, 46 clinicians

Practice addresses (Care Compare)

275 Collier NWRD
Atlanta, GA 30309-1700

275 Collier Rd NW
Suite 270
Atlanta, GA 30309-1700

Hospital & facility affiliations

  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Women'S Heathcare Specialists, LLC Obstetrics & Gynecology CurrentSince Nov 28, 2015 Accepting new patients
Atlanta Women'S Healthcare Specialists 3 LLC Obstetrics & Gynecology Past Accepting new patients
Orlando Health Inc Past Accepting new patients
Orlando Health Inc Past Accepting new patients

Locations

275 Collier Rd NW
Ste 100B
Atlanta, GA 30309
Phone (404) 352-1235

275 Collier Rd NW
Ste 100A
Atlanta, GA 30309
Phone (404) 352-1235

275 Collier Rd NW
Ste 100C
Atlanta, GA 30309
Phone (404) 355-0320

3925 Peachtree Rd NE
Ste 240
Brookhaven, GA 30319
Phone (404) 355-0320

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1407007115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061133",
            "telephone_number": "321-841-5560",
            "fax_number": "407-425-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061133",
            "telephone_number": "321-841-5560",
            "fax_number": "407-425-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKKAPATNAM",
        "first_name": "JAYASRI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME104383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.