Individual provider Active NPI

Kavya Madupu Rao, M.D

  • Neonatal-Perinatal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1609139799
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
294866 Issued in NY
Practice address
818 Ellicott St
Buffalo, NY 14203-1021
Phone
(716) 323-0260
Fax
(716) 323-0294
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neonatal-Perinatal Medicine Physician 2080N0001X 294866 NY Primary

Addresses

Primary practice location

818 Ellicott St
Buffalo, NY 14203-1021

Mailing address

1001 Main St FL 5
Buffalo, NY 14203-1009
Phone (716) 323-0260

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181003001389 NY Practitioner - Other (Physician)Practitioner - Pediatric Medicine 8426300401 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Jun 1, 2021 Accepting new patients
Kaleida Health CurrentSince Jun 1, 2021 Accepting new patients
University at Buffalo Pathologists, Inc Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 18, 2018 Accepting new patients
Kaleida Health Current Accepting new patients
University at Buffalo Pediatric Associates Inc CurrentSince Jun 1, 2021 Accepting new patients
Kaleida Health Past Accepting new patients
Kaleida Health Past Accepting new patients

Locations

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

100 High St
#13282
Buffalo, NY 14203

1001 Main St
Buffalo, NY 14203
Phone (716) 323-0225

100 E 77th St
Fl 3
New York, NY 10075
Phone (212) 434-2900

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

300 Community Dr
Plandome, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Interoperability endpoints

  • Direct secure messaging: krao311116@northwell.direct-ci.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1609139799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 ELLICOTT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031021",
            "telephone_number": "716-323-0260",
            "fax_number": "716-323-0294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAO",
        "first_name": "KAVYA",
        "middle_name": "MADUPU",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "294866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.