Suparna Dandamudi Patcha, M.B.B.S

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

298886-1 Issued in NY

Practice address

315 W 57TH St Ste 404
New York, NY 10019-3147

Phone

(888) 603-0993

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Suparna Patcha Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bodhi Medical Care, LLC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1649364639
  NPD
• Icahn School of Medicine at Mount Sinai

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1124392212
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1689724643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 414",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191819",
            "telephone_number": "888-603-9338",
            "fax_number": "212-624-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 57TH ST STE 404",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193147",
            "telephone_number": "888-603-0993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 E 72nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100214772",
            "country_code": "US",
            "telephone_number": "888-603-0993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450, East Kennedy Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "NJ",
            "postal_code": "08701",
            "country_code": "US",
            "telephone_number": "732-901-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANDAMUDI PATCHA",
        "first_name": "SUPARNA",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA066981",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "298886-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUPARNA",
            "last_name": "PATCHA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tequa Dancey
• Tyler John Dancho
• Karinna Esther Dancourt
• Renata Dancyger
• Julie Dancziger, LMSW
• Nadine Dandan, PHARMD
• Aparna Sharad Dandekar, M.D.
• Holly Heyward Dando, LCSW-R
• Kabir Dandona
• Denise Dandrades

• Pediatrics Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.