Individual provider Active NPI

Pradeepkumar Charla, MD

  • Pediatric Cardiology Physician
  • Rochester, NY
National Provider Identifier
1043516735
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
316270 Issued in NY
Practice address
62 Empire Blvd
Rochester, NY 14609-4356
Phone
(585) 565-2341
Fax
(949) 779-3303
NPI assigned
Jan 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Congenital Heart Disease Physician 207RA0002X 316270 NY
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 35.133440 OH
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X 35.133440 OH
Pediatric Cardiology Physician 2080P0202X 316270 NY Primary

Addresses

Primary practice location

62 Empire Blvd
Rochester, NY 14609-4356

Mailing address

62 Empire Blvd
Rochester, NY 14609-4356
Phone (585) 565-2341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220511000949 NY Practitioner - Pediatric Medicine 2769623206 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
316270NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Cardiology Multi-Specialty CurrentSince Jul 1, 2022 Accepting new patients
Congenital Heart Compass Medical PLLC Multi-Specialty CurrentSince Dec 7, 2025 Accepting new patients

Locations

601 Elmwood Ave
#635
Rochester, NY 14642
Phone (585) 275-2821

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

62 Empire Blvd
Rochester, NY 14609
Phone (585) 340-7402

Interoperability endpoints

  • Direct secure messaging: pcharlagorla@direct.iuhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1043516735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 EMPIRE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146094356",
            "telephone_number": "585-565-2341",
            "fax_number": "949-779-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 EMPIRE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146094356",
            "telephone_number": "585-565-2341",
            "fax_number": "949-779-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLA",
        "first_name": "PRADEEPKUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-28",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "NY",
            "license": "316270",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.133440",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OH",
            "license": "35.133440",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "316270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.