Individual provider Active NPI

Radhika Bompalli, M.D

  • Hospitalist Physician
  • Johnson City, NY
National Provider Identifier
1679975429
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
292597 Issued in NY
Practice address
33-57 Harrison St
Johnson City, NY 13790-2107
Phone
(607) 763-6622
Fax
(607) 763-5064
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD462668 PA
Hospitalist Physician 208M00000X MD462668 PA
Hospitalist Physician 208M00000X 292597 NY Primary

Addresses

Primary practice location

33-57 Harrison St
Johnson City, NY 13790-2107

Mailing address

33 Lewis Rd
2ND FL
Binghamton, NY 13905
Phone (607) 770-0025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20171121002481 PA Practitioner - Internal Medicine 4789941089 Reassigns benefits to 1 organization
I20210512003039 NY Practitioner - Hospitalist 4789941089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Medical Associates PCGroup PAC ID 0345144978, 229 clinicians

Practice addresses (Care Compare)

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6412

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Current Accepting new patients
United Medical Associates, P.C. CurrentSince Jun 1, 2021 Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine CurrentSince Oct 9, 2017 Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine CurrentSince Oct 9, 2017 Accepting new patients
United Medical Associates PC CurrentSince Jun 1, 2021 Accepting new patients
United Health Services Hospitals, Inc. Past Accepting new patients

Locations

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • FHIR API: https://epicproxy.et1127.epichosted.com/FHIRproxy/api/FHIR/R4/

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1679975429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "address_2": "2ND FL",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-770-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33-57 HARRISON ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902107",
            "telephone_number": "607-763-6622",
            "fax_number": "607-763-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMPALLI",
        "first_name": "RADHIKA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD462668",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD462668",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "292597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.