Bodavula MD LLC
NPI 1790183077ActiveOrganization· Clinic/Center· Creve Coeur, MO
Clinic/Center in Creve Coeur, Missouri, registered in NPPES in December 2014. The authorized official on file is Venkata Kr Bodavula, MD, Surgeon. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1790183077 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 18, 2014 |
| Last updated in NPPES | Dec 18, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | 2010007564 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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