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REVATHI KUDITHI
NPI 1639968779
Student in an Organized Health Care Education/Training Program in Baton Rouge, LA

Active since May 05, 2025PECOS Enrolled
3401 NORTH BOULEVARD BRG MID CITY MEDICINE CLINIC, SUITE 130, BATON ROUGE, LA 70806(225) 287-7900 Get Directions Write a Review

NPPES record last updated: October 31, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Revathi Kudithi NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVATHI KUDITHI (NPI 1639968779) is an individual student in an organized health care education/training program in Baton Rouge, Louisiana and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639968779
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameREVATHI KUDITHI
Location Address3401 NORTH BOULEVARD BRG MID CITY MEDICINE CLINIC, SUITE 130Baton Rouge, LA 70806
Mailing Address3401 North Boulevard Suite 130, Brg Mid City Medicine CBaton Rouge, LA 70806 · (225) 387-7900 · Fax (225) 442-5128
Phone(225) 287-7900
Sole ProprietorNo
Enumeration DateMay 5, 2025
Last NPPES UpdateOctober 31, 2025
NPPES CertifiedOctober 31, 2025
✔ NPI 1639968779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3401 NORTH BOULEVARD BRG MID CITY MEDICINE CLINIC, Baton Rouge, LA 70806
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revathi Kudithi is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revathi Kudithi's NPI number?

The NPI number for Revathi Kudithi is 1639968779. It was assigned to this individual provider in the NPPES registry on May 5, 2025.

Where is Revathi Kudithi located?

Revathi Kudithi practices at 3401 North Boulevard Brg Mid City Medicine Clinic Suite 130, Baton Rouge, LA 70806. The listed phone number is (225) 287-7900.

What is Revathi Kudithi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Revathi Kudithi enrolled in Medicare?

Yes. Revathi Kudithi is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Revathi Kudithi was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.