Baburao N Samudrala, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

138827-1 Issued in NY

Practice address

460 Andes Rd
Physicians Office Building
Delhi, NY 13753-7407

Phone

(607) 746-6266

Fax

(607) 746-6266

NPI assigned

May 27, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Leatherstocking Healthcare LLC

  dba Countryside Care Center

  • Skilled Nursing Facility
  • Delhi, NY
  • NPI 1801959275
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962459008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134130340",
            "telephone_number": "315-732-9368",
            "fax_number": "315-732-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 ANDES RD",
            "address_2": "PHYSICIANS OFFICE BUILDING",
            "city": "DELHI",
            "state": "NY",
            "postal_code": "137537407",
            "telephone_number": "607-746-6266",
            "fax_number": "607-746-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUDRALA",
        "first_name": "BABURAO",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "138827-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rippling Waters Retreat LLC
• Rite Aid of New York Inc (Rite Aid Pharmacy 01193)
• Lisa Roman, RD, CDN
• Round the Clock Nurses
• Edith Ann Sabatini, RN
• Sean E Secord, P.A.
• Jeanne Mae Shaw, R.N.
• Kyra Shew
• Gilbert Charles Simpkins, FNP
• R. B. Kelley Snodgrass, D.C.

• Family Medicine Physician in Delhi, NY
• Providers in Delhi, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.

Verify at the official NPI Registry.