Individual provider Active NPI

Das B Madala

  • Pharmacist
  • New York, NY
National Provider Identifier
1114100591
Registry record updated Dec 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
032429 Issued in NY
Practice address
2 Penn PLZ
Penn Station Amtrak Level
New York, NY 10121-0101
Phone
(212) 760-8107
NPI assigned
Dec 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 032429 NY Primary

Addresses

Primary practice location

2 Penn PLZ
Penn Station Amtrak Level
New York, NY 10121-0101

Mailing address

2 Penn PLZ
Penn Station Amtrak Level
New York, NY 10121-0101
Phone (212) 760-8107

Other identifiers 1

IdentifierTypeStateIssuer
01308621MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
032429NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1197158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197158400000",
    "number": "1114100591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PENN PLZ",
            "address_2": "PENN STATION AMTRAK LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101210101",
            "telephone_number": "212-760-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PENN PLZ",
            "address_2": "PENN STATION AMTRAK LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101210101",
            "telephone_number": "212-760-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADALA",
        "first_name": "DAS",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-09",
        "last_updated": "2007-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "032429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01308621",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.