Individual provider Active NPI

Sita M Boppana, M.D.

  • Internal Medicine Physician
  • Richardson, TX
National Provider Identifier
1689629123
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K3994 Issued in TX
Practice address
2460 N Central Expy
Suite 101
Richardson, TX 75080-2713
Phone
(972) 644-1100
Fax
(972) 644-1107
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K3994 TX Primary

Addresses

Primary practice location

2460 N Central Expy
Suite 101
Richardson, TX 75080-2713

Mailing address

PO Box 830066
Richardson, TX 75083-0066
Phone (972) 644-1100

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091205000130 TX Practitioner - Internal Medicine 3476564402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2460 N Central Expy
Suite 101
Richardson, TX 75080-2780
Phone (972) 644-1100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boppana Primary Care Clinic, PLLC Internal Medicine CurrentSince Dec 27, 2001 Accepting new patients

Locations

2460 N Central Expy
Ste 101
Richardson, TX 75080
Phone (469) 501-2224

Interoperability endpoints

  • Direct secure messaging: sita.boppana@bpcc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EIBEAA/Endpoint/EIBEAA

Organizations & group practices 1

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 2

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1689629123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830066",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750830066",
            "telephone_number": "972-644-1100",
            "fax_number": "972-644-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N CENTRAL EXPY",
            "address_2": "SUITE 101",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802713",
            "telephone_number": "972-644-1100",
            "fax_number": "972-644-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOPPANA",
        "first_name": "SITA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.