Srinivas S Boppana, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS15193 Issued in FL

Practice address

5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327

Phone

(727) 824-0780

Fax

(813) 814-8891

NPI assigned

Apr 8, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

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 2

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srinivas.boppana.1@30093.direct.athenahealth.com

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.

• Optumcare Florida LLC

  dba Optum

  • General Practice Physician
  • Tampa, FL
  • NPI 1053384214
  Medicare reassignment Care Compare group
• Premium Primary Care & Walk-in Clinic Inc

  • Family Medicine Physician
  • Port St Lucie, FL
  • NPI 1700654167

  Single Specialty

  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Single Specialty

  Medicare reassignment NPD
• Montefiore Medical Center

  dba Montefiore Community Pharmacy @ CHAM

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

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

{
    "created_epoch": "1333843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1679839252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780",
            "fax_number": "813-814-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780",
            "fax_number": "813-814-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOPPANA",
        "first_name": "SRINIVAS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-08",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS017249",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS15193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Booth, PHD
• Canesia V Booth, BS,RKT
• Mary Watts Booth, MS CCCSLP
• Rene A Boothby, MD
• Madison Bootz, PA-C
• Robert Carl Borchard Jr.
• Whitney Borchardt
• Stephen Michael Borchik, ATC
• Christopher Jacob Bordelon, PA-C
• Rachel Ann Ehrlich Bordelon, DO

• Family Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.

Verify at the official NPI Registry.