MAHESH BOMMARAJU (NPI# 1457328114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457328114 |
| Entity Type | Individual |
| Full Name | MAHESH BOMMARAJU |
| Credential | MD |
| Practice Address |
1540 Maple Rd Williamsville NY 14221-3647 |
| Mailing Address |
219 Bryant St Buffalo NY 14222-2006 |
| Practice Telephone | 7168787662 |
| Mailing Telephone | 7168787673 |
| Mailing Fax Number | 7168787945 |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2010-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
190900 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01564185 | 05 | |
| FIDELIS | 040426000926 | 01 | |
| IHA | 3610082 | 01 | |
| BC/BS | 000523290004 | 01 | |
| UNIVERA | 00010018901 | 01 |
| Street Address |
1540 MAPLE RD |
| City | WILLIAMSVILLE |
| State | NY |
| Zip Code | 14221-3647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023002516 | Buffalo Hospitalist Services, P.C. | Internal Medicine | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2005-09-11 |
| 1730789462 | Stacey Thompson | Nurse Practitioner | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2020-10-30 |
| 1942836788 | Victoria Catherine Suto | Physician Assistant | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2020-03-12 |
| 1831722800 | Jessica Nicole Kaczor | Emergency Medicine | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2020-02-19 |
| 1720628613 | Sarah Ann Sporski | Family Medicine | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2020-01-08 |
| 1447892187 | Lauren Nicole Urie | Physician Assistant | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2019-10-15 |
| 1831746734 | Nicole Marie Zahn | Nurse Practitioner | 1540 Maple Rd, Williamsville, NY 14221-3698 | 2019-08-25 |
| 1295392876 | Charnelle Lewis | Nurse Anesthetist, Certified Registered | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2019-05-20 |
| 1962968545 | Lauren Fial | Physician Assistant | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2019-02-19 |
| 1275097578 | Megan K Mase | Nurse Practitioner | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2019-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447552 | Kuldesh Singh Ubhi | Student in an Organized Health Care Education/Training Program | 850 Hoplins Road, Williamsville, NY 14221 | 2020-11-04 |
| 1992304968 | Nicholas Robinson | Nurse Practitioner | 295 Essjay, Williamsville, NY 14221 | 2020-10-21 |
| 1457961104 | Maria Fagant | Licensed Practical Nurse | 2550 Wehrle Drive Suite 1, Williamsville, NY 14221 | 2020-08-07 |
| 1073136362 | Nicole Marie Mauro | Licensed Practical Nurse | 2550 Wehrle Drive, Williamsville, NY 14221 | 2020-05-21 |
| 1982258422 | Schenk Primary Care Medicine, Pllc | Clinic/Center | 2350 Maple Road Suite 100, Amherst, NY 14221 | 2019-08-01 |
| 1669031365 | Anh Thi Nguyet Phan | Student in an Organized Health Care Education/Training Program | 850 Hopkins Rd., Williamsville, NY 14221 | 2019-06-07 |
| 1801453394 | Buffalo Medical Group, PC | Clinic/Center | 325 Essjay, Williamsville, NY 14221 | 2019-05-21 |
| 1265097265 | Christine Marie Wolniewicz | Dietitian, Registered | 507 Maple Rd., Williamsville, NY 14221 | 2019-05-06 |
| 1750844957 | Myles S Faith | Psychologist | 190 Rollingwood Street, Williamsville, NY 14221 | 2019-04-13 |
| 1902376536 | Shane Michael Stadtmueller | Chiropractor | 5820 Main St. Suite 201, Williamsville, NY 14221 | 2018-11-27 |
| Find all providers in zip 14221 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588633051 | Ann Marie Reynolds | Pediatrics | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2006-03-16 |
| 1639148570 | Ralph Wynn | Pediatrics | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2006-03-14 |
| 1043288103 | Frederick C Morin IIi | Pediatrics | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2006-03-14 |
| 1659348266 | Vivien Carrion | Pediatrics | 1540 Maple Rd, Williamsville, NY 14221-3647 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447893193 | Karen Lynn Marsh | Pediatrics | 64 Willow St, Guilderland, NY 12084-9778 | 2019-10-25 |
| 1497227094 | Alison Kent | Pediatrics | Dept of Pediatrics, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642 | 2018-12-20 |
| 1639697329 | Lily Michelle Barres | Pediatrics | 601 Elmwood Ave Box 651, Rochester, NY 14642-0001 | 2017-09-01 |
| 1093238339 | Maria Pygerou-kofinas | Pediatrics | 506 Sixth Street Kp4, Brooklyn, NY 11215 | 2017-07-19 |
| 1063893089 | Namirembe Joan Kazibwe | Pediatrics | 539, 85th Street, Apt 3f, Brooklyn, NY 11209 | 2015-06-16 |
| 1114339322 | Michelle Quan | Pediatrics | 388 Bridge St, Apt 11b, Brooklyn, NY 11201-5210 | 2014-05-21 |
| 1215347026 | Babina K Nayak | Pediatrics | 435 Avalon Gardens Dr Apt 435, Nanuet, NY 10954-7433 | 2014-05-01 |
| 1952728883 | Thomas Hays | Pediatrics | 41 Hausman St, Brooklyn, NY 11222 | 2014-03-28 |
| 1437597614 | Umesh Paudel | Pediatrics | 100 Woods Rd Pmb 605, Valhalla, NY 10595 | 2013-06-10 |
| 1144668484 | Irina Kaminyar | Pediatrics | 24023 68th Ave, Douglaston, NY 11362-1928 | 2013-06-09 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSVILLE |
| Zip Code | 14221 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.