Active NPI
David Gabriel Prado, D.O.
- Psychiatry Physician
- Philadelphia, PA
National Provider Identifier
1073946919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OT015466
- Practice address
- 230 N Broad St
Philadelphia, PA 19102-1121 - Phone
- (215) 762-7000
- NPI assigned
- Aug 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OT015466 | PA | Primary |
Addresses
Primary practice location
230 N Broad St
Philadelphia, PA 19102-1121
Mailing address
230 N Broad St
Philadelphia, PA 19102-1121
Phone (215) 762-7000
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT015466 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1073946919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021121",
"telephone_number": "215-762-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021121",
"telephone_number": "215-762-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRADO",
"first_name": "DAVID",
"middle_name": "GABRIEL",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-14",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "OT015466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.