Roopa Jagadeesh Hathwar, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

222906-1 Issued in NY

Practice address

123 Conhocton St Ste 101
Corning, NY 14830-2959

Phone

(607) 438-1200

Fax

(607) 438-1221

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Arnot Ogden Medical Center

  • General Acute Care Hospital
  • Elmira, NY
  • NPI 1083605661
  NPD (past)
• Chemung Medical Services PC

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1356378889
  NPD (past)
• Fort Edward Rescue Squad Inc

  • Ambulance
  • Fort Edward, NY
  • NPI 1427031319
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1861435620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 CONHOCTON ST STE 101",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302959",
            "telephone_number": "607-438-1200",
            "fax_number": "607-438-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHWAR",
        "first_name": "ROOPA",
        "middle_name": "JAGADEESH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "222906-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102808363",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02200815",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evella Denean Harrell, LPN
• Danica Harvey, RPH
• Khwaja Yousuf Hasan, MD
• Joseph E Hatef, DPM
• Jagadeesh Sreenevasa Hathwar, M.D.
• Megan Hawk, RPH
• Sydney Hayden, PT, DPT
• Timothy Atwood Hayden, OTR/L
• Joseph Hayes
• Nacole Headrick, RN

• Internal Medicine Physician in Corning, NY
• Providers in Corning, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.