Individual provider Active NPI

Priyanka Vakati, M.D

  • Pediatrics Physician
  • Newark, DE
National Provider Identifier
1124433024
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C1-0012104 Issued in DE
Practice address
4755 Ogletown Stanton Rd Dept of
Newark, DE 19718-2200
Phone
(302) 733-4200
Fax
(718) 613-8677
NPI assigned
Jun 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 C1-0012104 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd Dept of
Newark, DE 19718-2200

Mailing address

200 Hygeia Dr Ste 2300
Newark, DE 19713-2049
Phone (718) 270-2078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231113000907 CA Practitioner - Pediatric Medicine 4082982863 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0012104DEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tpirc Medical Foundation Inc Pediatrics CurrentSince Oct 3, 2023 Accepting new patients

Locations

701 E 28th St
Ste 419
Long Beach, CA 90806
Phone (562) 424-8000

2704 E Willow St
Signal Hill, CA 90755
Phone (562) 595-0203

Interoperability endpoints

  • Direct secure messaging: priyanka.vakati.1@11920.direct.athenahealth.com

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124433024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR STE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049",
            "telephone_number": "718-270-2078",
            "fax_number": "718-613-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD DEPT OF",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-4200",
            "fax_number": "718-613-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKATI",
        "first_name": "PRIYANKA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C1-0012104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.