Individual provider Active NPI

Bellamkonda S Raghu, M.D.

  • Psychiatry Physician
  • Amherst, NY
National Provider Identifier
1922050012
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD194173 Issued in NY
Practice address
4985 Harlem Road
Amherst, NY 14226
Phone
(716) 839-0500
Fax
(716) 839-0523
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 194173 NY
Psychiatry Physician 2084P0800X MD194173 NY Primary

Addresses

Primary practice location

4985 Harlem Road
Amherst, NY 14226

Mailing address

4985 Harlem Road
Amherst, NY 14226
Phone (716) 839-0500

Other identifiers 1

IdentifierTypeStateIssuer
01843232MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
194173NYMDPsychiatry Physician
MD194173NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Day Kimball Healthcare, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Catholic Charities Inc - Archdiocese of Hartford CurrentSince Mar 7, 2016 Accepting new patients
Day Kimball Healthcare, Inc. Psychiatry CurrentSince Aug 1, 2020 Accepting new patients
Horizon Health Services Inc PastSince Sep 1, 2019 Accepting new patients
Niagara Frontier Psychiatric Associates Psychiatry Past Accepting new patients

Locations

45 Wadsworth St
Hartford, CT 06106
Phone 8605271124283

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

Organizations & group practices 5

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1922050012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 HARLEM ROAD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-839-0500",
            "fax_number": "716-839-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4985 HARLEM ROAD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-839-0500",
            "fax_number": "716-839-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHU",
        "first_name": "BELLAMKONDA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "194173",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "MD194173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01843232",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.