Individual provider Active NPI

Chandhana Paka, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • New York, NY
National Provider Identifier
1063746840
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
285370-1 Issued in NY
Practice address
425 W 59TH St # 4B
New York, NY 10019-8022
Phone
(212) 581-8675
Fax
(212) 459-9113
NPI assigned
Sep 25, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 285370-1 NY Primary

Addresses

Primary practice location

425 W 59TH St # 4B
New York, NY 10019-8022

Mailing address

425 W 59TH St # 4B
New York, NY 10019-8022
Phone (212) 581-8675

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
I20161230000511 NY Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 0941441703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, shared by 32 NPIs, 2,809 clinicians

Practice addresses (Care Compare)

10 Union SQ E
New York, NY 10003-3314
Phone (212) 844-8590

425 W 59TH St
New York, NY 10019-8022
Phone (212) 523-8670

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285370-1NYMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 2, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 2, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

425 W 59th St
New York, NY 10019
Phone (212) 376-3180

200 W 57th St
Ste 1300
New York, NY 10019
Phone (212) 523-6333

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

425 W 59th St
#4B
New York, NY 10019
Phone (212) 523-7570

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

1000 10th Ave
Ste 10C
New York, NY 10019
Phone (212) 523-3452

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1063746840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W 59TH ST # 4B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100198022",
            "telephone_number": "212-581-8675",
            "fax_number": "212-459-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 59TH ST # 4B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100198022",
            "telephone_number": "212-581-8675",
            "fax_number": "212-459-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKA",
        "first_name": "CHANDHANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-25",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NY",
            "license": "285370-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.