Individual provider Active NPI

Anuradha M Bhimavarapu, M.D.

  • Pediatrics Physician
  • Randolph, MA
National Provider Identifier
1447207691
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
155695 Issued in MA
Practice address
25 Warren St
Randolph, MA 02368-4015
Phone
(781) 986-7900
Fax
(508) 894-0412
NPI assigned
May 30, 2006
Last updated
Jan 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 155695 MA Primary

Addresses

Primary practice location

25 Warren St
Randolph, MA 02368-4015

Mailing address

25 Warren St
Randolph, MA 02368-4015
Phone (781) 986-7800

Other practice location 1

179, quincy street, Brockton, MA 02302
Braintree Allied Pediatrics P.C.,
Braintree, MA02184, MA 02184
Phone (781) 849-1215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190723000409 MA Practitioner - Pediatric Medicine 6507192069 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Hospital, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Brockton Hospital, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Signature Healthcare Medical Group Inc Pediatrics CurrentSince Aug 1, 2019 Accepting new patients

Locations

179 Quincy St
Brockton, MA 02302
Phone (508) 427-7700

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

25 Warren St
Randolph, MA 02368
Phone (781) 986-7800

1524 Turnpike St
Stoughton, MA 02072
Phone (781) 886-3020

Interoperability endpoints

  • Direct secure messaging: anuradha.bhimavarapu@direct.signature.masshiway.net

Organizations & group practices 3

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1447207691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WARREN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684015",
            "telephone_number": "781-986-7800",
            "fax_number": "508-894-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WARREN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684015",
            "telephone_number": "781-986-7900",
            "fax_number": "508-894-0412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "179, quincy street, Brockton, MA 02302",
            "address_2": "Braintree Allied Pediatrics P.C.,",
            "address_purpose": "LOCATION",
            "city": "Braintree, MA02184",
            "state": "MA",
            "postal_code": "02184",
            "country_code": "US",
            "telephone_number": "781-849-1215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHIMAVARAPU",
        "first_name": "ANURADHA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "155695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

Verify at the official NPI Registry.