Individual provider Active NPI

Suneetha Potluri, RPA-C

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1861700221
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014095-1 Issued in NY
Practice address
600 E 233Rd St
Bronx, NY 10466-2604
Phone
(718) 430-3204
NPI assigned
Sep 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014095-1 NY Primary

Addresses

Primary practice location

600 E 233Rd St
Bronx, NY 10466-2604

Mailing address

1580 Pelham Pkwy S
Apt # 1L
Bronx, NY 10461-1112
Phone (347) 657-0653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171204000861 NC Practitioner - Physician Assistant 8820355605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220

430 Waterstone Dr
Hillsborough, NC 27278-9078
Phone (984) 215-2000

460 Waterstone Dr
Hillsborough, NC 27278-9078
Phone (984) 215-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014095-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince May 16, 2017 Accepting new patients

Locations

101 Manning Dr
#7570
Chapel Hill, NC 27514
Phone (919) 966-4150

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Interoperability endpoints

  • Direct secure messaging: spotluri286368@direct.unc.nchie.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1861700221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 PELHAM PKWY S",
            "address_2": "APT # 1L",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611112",
            "telephone_number": "347-657-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-430-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTLURI",
        "first_name": "SUNEETHA",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014095-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.