Individual provider Active NPI

Kanthimathi Jothianandan, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1033299318
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
150101 Issued in NY
Practice address
57 East Mt Eden Ave
Bronx, NY 10452
Phone
(718) 901-4111
Fax
(718) 731-5549
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 150101 NY Primary

Addresses

Primary practice location

57 East Mt Eden Ave
Bronx, NY 10452

Mailing address

57 East Mt Eden Ave
Bronx, NY 10452
Phone (718) 901-4111

Other identifiers 1

IdentifierTypeStateIssuer
00760196MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
150101NYMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033299318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 EAST MT EDEN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10452",
            "telephone_number": "718-901-4111",
            "fax_number": "718-731-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 EAST MT EDEN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10452",
            "telephone_number": "718-901-4111",
            "fax_number": "718-731-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOTHIANANDAN",
        "first_name": "KANTHIMATHI",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "150101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00760196",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.