Individual provider Active NPI

Gitendra Bommareddy, R.PH

  • Pharmacist
  • Lutz, FL
National Provider Identifier
1508090242
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS 44601 Issued in FL
Practice address
18474 N US Highway 41
Lutz, FL 33549-4469
Phone
(269) 501-7359
NPI assigned
May 10, 2009
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS 44601 FL Primary

Addresses

Primary practice location

18474 N US Highway 41
Lutz, FL 33549-4469

Mailing address

23170 Scaglione Dr
Lutz, FL 33549-5763
Phone (269) 501-7359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS 44601FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mookambika Inc CurrentSince Aug 4, 2024 Accepting new patients
Bhesaja LLC CurrentSince Aug 25, 2025 Accepting new patients
The Ausadha LLC Current Accepting new patients
The Ausadha LLC Current Accepting new patients

Locations

18474 N US Highway 41
Lutz, FL 33549
Phone (813) 304-4340

Organizations & group practices 5

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": "1241913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1508090242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23170 SCAGLIONE DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335495763",
            "telephone_number": "269-501-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18474 N US HIGHWAY 41",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494469",
            "telephone_number": "269-501-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMMAREDDY",
        "first_name": "GITENDRA",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-10",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 44601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.