Bharath Raj Kidambi, MBBS MD DM

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

353995 Issued in LA

Practice address

422 Kade St Ste 1
Jennings, LA 70546-3657

Phone

(337) 388-6200

Fax

(337) 388-6201

NPI assigned

Dec 17, 2024

Reactivated

Oct 27, 2025

Last updated

Aug 18, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1699582247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 KADE ST STE 1",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463657",
            "telephone_number": "337-388-6200",
            "fax_number": "337-388-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 KADE ST STE 1",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463657",
            "telephone_number": "337-388-6200",
            "fax_number": "337-388-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDAMBI",
        "first_name": "BHARATH RAJ",
        "name_prefix": "Mr.",
        "credential": "MBBS MD DM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "deactivation_date": "2025-09-19",
        "reactivation_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "353995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in Jennings, LA
• Providers in Jennings, LA by specialty
• Interventional Cardiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.