Individual provider Active NPI

Bala Bhaskar Reddy Bhimavarapu, MD

  • Pediatrics Physician
  • Wichita, KS
National Provider Identifier
1699111484
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
04-38863 Issued in KS
Practice address
848 N Saint Francis St Ste 3901
Wichita, KS 67214
Phone
(316) 268-5000
NPI assigned
May 20, 2013
Last updated
May 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 04-38863 KS Primary

Addresses

Primary practice location

848 N Saint Francis St Ste 3901
Wichita, KS 67214

Mailing address

PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135

Other identifiers 1

IdentifierTypeStateIssuer
003719466OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20160520002055 KS Practitioner - Pediatric Medicine 4688970932 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 1, 2016 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 1, 2016 Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients
Wesley Medical Center LLC Past Accepting new patients

Locations

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

848 N Saint Francis Ave
Ste 3901
Wichita, KS 67214
Phone (316) 268-7030

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1699111484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135",
            "fax_number": "316-689-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 N SAINT FRANCIS ST STE 3901",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67214",
            "telephone_number": "316-268-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHIMAVARAPU",
        "first_name": "BALA BHASKAR REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-38863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.