NPIMap

Organization Active NPI

Rekha Padubidri, MD Inc

  • Internal Medicine Physician
  • Youngstown, OH
National Provider Identifier
1952594434
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
REKHA PADUBIDRI, MD INC
Practice address
725 Boardman Canfield Rd
BLDG J2
Youngstown, OH 44512-4380
Phone
(330) 726-0001
Fax
(330) 726-1828
NPI assigned
Aug 20, 2007
Last updated
Mar 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Cyndee Fisher
Title
Billing Manager
Phone
(330) 270-5454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OH Primary

Addresses

Primary practice location

725 Boardman Canfield Rd
BLDG J2
Youngstown, OH 44512-4380

Mailing address

725 Boardman Canfield Rd
BLDG J2
Youngstown, OH 44512-4380
Phone (330) 726-0001

Other identifiers 2

IdentifierTypeStateIssuer
000000344723OtherOHANTHEM BCBS
2521533MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041118000675 OH Part B Supplier - Clinic/Group Practice 1254395205 Receives reassigned benefits from 1 practitioner
Practice locations: Youngstown, OH

National Provider Directory

National Provider Directory

Locations

602 Parmalee Ave
Youngstown, OH 44510
Phone (330) 743-2473

602 Parmalee Ave
Ste 200
Youngstown, OH 44510
Phone (330) 743-2473

725 Boardman Canfield Rd
Ste J2
Youngstown, OH 44512
Phone (330) 533-3427

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1952594434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD",
            "address_2": "BLDG J2",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-726-0001",
            "fax_number": "330-726-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD",
            "address_2": "BLDG J2",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-726-0001",
            "fax_number": "330-726-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REKHA PADUBIDRI, MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "CYNDEE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "330-270-5454"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000344723",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2521533",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.