Individual provider Active NPI

Pronoti Nigam, MD

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1053390310
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C43125 Issued in CA
Practice address
4205 San Felipe Rd
Suite 110
San Jose, CA 95135-1503
Phone
(408) 238-8303
Fax
(408) 238-8375
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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 C43125 CA Primary

Addresses

Primary practice location

4205 San Felipe Rd
Suite 110
San Jose, CA 95135-1503

Mailing address

4205 San Felipe Rd
#110
San Jose, CA 95135-1503
Phone (408) 238-8303

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
C43125CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Pediatrics Inc Pediatrics Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDDABA/Endpoint/BDDABA

Organizations & group practices 1

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1053390310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 SAN FELIPE RD",
            "address_2": "#110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351503",
            "telephone_number": "408-238-8303",
            "fax_number": "408-238-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 SAN FELIPE RD",
            "address_2": "SUITE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351503",
            "telephone_number": "408-238-8303",
            "fax_number": "408-238-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIGAM",
        "first_name": "PRONOTI",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C43125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.