Provider Demographics
NPI:1154324127
Name:KALAPATAPU, KUMAR SIVA (MD)
Entity Type:Individual
Prefix:DR
First Name:KUMAR
Middle Name:SIVA
Last Name:KALAPATAPU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 168TH ST # 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-305-9817
Mailing Address - Fax:914-593-7881
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:STE 700
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-593-7800
Practice Address - Fax:914-593-7857
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207037207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01785813Medicaid
NYA400038241OtherMEDICARE PTAN
NY27N8335223OtherPTAN
NY060047444OtherRAIL ROAD MEDICARE
NY27N833K221OtherPTAN
NY27N833K221OtherPTAN
NY27N831Medicare ID - Type Unspecified
NYA400038241OtherMEDICARE PTAN
NYA400061881Medicare PIN