Individual provider Active NPI

Padma Nandula

  • Pediatrics Physician
  • Milwaukee, WI
National Provider Identifier
1114118338
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
56826 Issued in WI
Practice address
9000 W Wisconsin Ave
Division of Neonatology
Milwaukee, WI 53226-4874
Phone
(414) 266-6820
Fax
(414) 266-6979
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301090534 MI
Pediatrics Physician 208000000X 56826 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Division of Neonatology
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Division of Neonatology
Milwaukee, WI 53226-4874
Phone (414) 266-6820

Other identifiers 1

IdentifierTypeStateIssuer
1114118338MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150710000316 FL Practitioner - Pediatric Medicine 2860679206 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56826WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Pediatrics CurrentSince Jul 1, 2015 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2015 Accepting new patients

Locations

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Interoperability endpoints

  • Direct secure messaging: pnandula184175@direct.shands.ufl.edu

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1114118338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6820",
            "fax_number": "414-266-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6820",
            "fax_number": "414-266-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDULA",
        "first_name": "PADMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301090534",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "56826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114118338",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.