Active NPI
Bellamkonda S Raghu, M.D.
- Psychiatry Physician
- Amherst, NY
National Provider Identifier
1922050012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD194173
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01843232 | Medicaid | NY |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 194173 | NY | MD | Psychiatry Physician |
| MD194173 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Day Kimball Healthcare, Inc. | Current | Accepting new patients | |
| Catholic Charities Inc - Archdiocese of Hartford | Current | Accepting new patients | |
| Day Kimball Healthcare, Inc. | Psychiatry | Current | Accepting new patients |
| Horizon Health Services Inc | Past | 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
- 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hartford, CT
- NPI 1245324516
-
- Community/Behavioral Health Agency
- Putnam, CT
- NPI 1104680966
-
- Community/Behavioral Health Agency
- Getzville, NY
- NPI 1043387152
-
- Psychiatry Physician
- Amherst, NY
- NPI 1265462493
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.