Active NPI
Sreenand Boddu
- Diagnostic Radiology Physician
- Dallas, TX
National Provider Identifier
1669050100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- W3769
- Practice address
- 6201 Harry Hines Blvd
Dallas, TX 75390-7201 - Phone
- (214) 648-7962
- NPI assigned
- Mar 29, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | W3769 | TX | Primary |
Addresses
Primary practice location
6201 Harry Hines Blvd
Dallas, TX 75390-7201
Mailing address
1425 Portland Ave
Rochester, NY 14621-3011
Other practice location 1
1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260519004584 | TX | Practitioner - Diagnostic Radiology | 2163822701 |
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5323 Harry Hines Blvd
Dallas, TX 75390-7208
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| W3769 | TX | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1669050100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 PORTLAND AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146213011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6201 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "753907201",
"telephone_number": "214-648-7962"
}
],
"practiceLocations": [
{
"address_1": "1425 Portland Ave",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "NY",
"postal_code": "146213011",
"country_code": "US",
"telephone_number": "585-922-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BODDU",
"first_name": "SREENAND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-29",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "W3769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.