Active NPI
Suchitha Bodapati, M.D
- Pediatrics Physician
- Babylon, NY
National Provider Identifier
1710109780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 194434
- Practice address
- 421 Deer Park Avenue
Babylon, NY 11702 - Phone
- (631) 661-3693
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 194434 | NY | Primary |
Addresses
Primary practice location
421 Deer Park Avenue
Babylon, NY 11702
Mailing address
66 West Lane
Bayshore, NY 11706
Phone (631) 647-4967
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 194434 | NY | MD | Pediatrics Physician |
Interoperability endpoints
- suchitha.bodapati@thirdavepeds.ehi.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710109780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 WEST LANE",
"city": "BAYSHORE",
"state": "NY",
"postal_code": "11706",
"telephone_number": "631-647-4967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 DEER PARK AVENUE",
"city": "BABYLON",
"state": "NY",
"postal_code": "11702",
"telephone_number": "631-661-3693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODAPATI",
"first_name": "SUCHITHA",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "194434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Babylon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.