Active NPI
Pradeep Sharma, MD
- Allergy & Immunology Physician
- Poughkeepsie, NY
National Provider Identifier
1144203159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 1115831
- Practice address
- 29 Fox Street
Poughkeepsie, NY 12601 - Phone
- (845) 454-1234
- Fax
- (845) 454-1898
- NPI assigned
- Nov 23, 2005
- 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 |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 1115831 | NY | Primary |
Addresses
Primary practice location
29 Fox Street
Poughkeepsie, NY 12601
Mailing address
16 Stoutenburgh Drive
Hyde Park, NY 12538
Phone (845) 229-0209
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00526476 | Medicaid | NY |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1115831 | NY | MD | Allergy & Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278374400000",
"number": "1144203159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 STOUTENBURGH DRIVE",
"city": "HYDE PARK",
"state": "NY",
"postal_code": "12538",
"telephone_number": "845-229-0209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 FOX STREET",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "12601",
"telephone_number": "845-454-1234",
"fax_number": "845-454-1898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARMA",
"first_name": "PRADEEP",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2010-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "NY",
"license": "1115831",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00526476",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poughkeepsie, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.