Active NPI
Amudha Boopathi, M.D.,
- General Practice Physician
- Millsboro, DE
National Provider Identifier
1902194376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- C10011009
- Practice address
- 30265 Commerce Dr
Millsboro, DE 19966-3593 - Phone
- (302) 629-5050
- Fax
- (302) 629-5053
- NPI assigned
- Jul 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | C10011009 | DE | Primary |
| Pediatrics Physician | 208000000X | C1-0011009 | DE |
Addresses
Primary practice location
30265 Commerce Dr
Millsboro, DE 19966-3593
Mailing address
PO Box 191
Rockland, DE 19732-0191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103448773 | Medicaid | PA |
Other names 1
- Amudha Palaniappan
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 |
|---|---|---|---|
| C1-0011009 | DE | MD | Pediatrics Physician |
| C10011009 | DE | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Past | Accepting new patients |
Interoperability endpoints
- amudhaboopathi@dhni.allscriptsdirect.net
- aboopathi44193@direct.nemours.org
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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1902194376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30265 COMMERCE DR",
"city": "MILLSBORO",
"state": "DE",
"postal_code": "199663593",
"telephone_number": "302-629-5050",
"fax_number": "302-629-5053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOPATHI",
"first_name": "AMUDHA",
"name_prefix": "Dr.",
"credential": "M.D.,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-19",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "DE",
"license": "C10011009",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C1-0011009",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103448773",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMUDHA",
"last_name": "PALANIAPPAN",
"credential": "M.D.,",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Millsboro, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.