MAHESH BOMMARAJU MD NPI 1457328114

NPI Information

  • NPI: 1457328114
  • Provider Name: MAHESH BOMMARAJU, MD
  • Classification: Pediatrics - 2080N0001X
  • Specialization: Neonatal-Perinatal Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1540 MAPLE RD
    WILLIAMSVILLE, NY
    ZIP 14221
  • Phone: (716) 878-7662

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NPI Details

Mahesh Bommaraju, MD is a neonatal-perinatal medicine pediatrics in Williamsville, NY. The provider is 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. Mahesh Bommaraju, MD NPI is 1457328114. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1540 MAPLE RD
WILLIAMSVILLE, NY
ZIP 14221-647
Phone: (716) 878-7662

The NPI 1457328114 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/2/2006 and was last updated on 1/11/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080N0001XPediatricsNeonatal-Perinatal Medicine190900NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100010018901OTHERUNIVERA
2040426000926OTHERFIDELIS
3F80735MEDICARE UPINNEW YORK
4BB1985MEDICARE PINNEW YORK
501564185MEDICAIDNEW YORK
6000523290004OTHERBC/BS
73610082OTHERIHA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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