Active NPI
Akila Venkataraman, MD
- Neurology with Special Qualifications in Child Neurology Physician
- Wilkes Barre, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- MD471964
- Practice address
- 1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027 - Phone
- (570) 808-7300
- NPI assigned
- Sep 19, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | 001613 | NY | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | MD471964 | PA | Primary |
Addresses
Primary practice location
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02350567 | Medicaid | NY | |
| 2603656 | Other | NY | GHI |
| 0100559 | Other | NY | AMERICHOICE |
| 2196604 04 | Other | NY | UNITED HEALTHCARE |
| 7863378 | Other | NY | AETNA PPO |
| P2640917 | Other | NY | OXFORD HEALTH PLAN |
| 127400101 | Other | NY | HEALTH PLUS |
| 001613-A15 | Other | NY | HEALTH FIRST |
| 501Z91 | Other | NY | EMPIRE BCBS |
| 1000028191 | Other | NY | AFFINITY HEALTH |
| 2969639 | Other | NY | AETNA USHC HMO |
| 4C2294 | Other | NY | HEALTH NET |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | avenkataraman312129@direct.geisinger.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD471964 | PA | MD | Neurology with Special Qualifications in Child Neurology Physician |
| 001613 | NY | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Physicians of University Hospital, PC | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Evangelical Medical Services Organization | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| Evangelical Medical Services Organization | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| Physicians of University Hospital, PC | Current | Accepting new patients | |
| Evangelical Medical Services Organization | Current | Accepting new patients | |
| NYU Lutheran Medical Center | Past | Accepting new patients | |
| MMC Pediatrics Faculty Practice | Past | Accepting new patients | |
| Geisinger Clinic | Past | Accepting new patients | |
| Geisinger Wyoming Valley Medical Center | Past | Accepting new patients |
Locations
150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477
8714 5th Ave
Brooklyn, NY 11209
Phone (718) 630-8600
150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185
4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724
100 E 77th St
New York, NY 10075
Phone (212) 434-2606
403 E 34th St
Fl 4
New York, NY 10016
Phone (212) 263-8870
223 E 34th St
New York, NY 10016
Phone (212) 263-8854
550 1st Ave
New York, NY 10016
Phone (212) 263-3293
300 Community Dr
Plandome, NY 11030
1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047
242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458
501 Seaview Ave
Staten Island, NY 10305
Phone (718) 667-4700
401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186
972 Brush Hollow Rd
Westbury, NY 11590
100 N Academy Ave
Danville, PA 17822
25 Lystra Rogers Dr
Lewisburg, PA 17837
Phone (570) 523-3290
3 Hospital Dr
Ste 206
Lewisburg, PA 17837
Phone (570) 522-9771
1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399
1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300
Interoperability endpoints
- avenkataraman489664@wellspan.direct-ci.com
Organizations & group practices 14
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.
-
- Surgery Physician
- Lewisburg, PA
- NPI 1205928967
-
- Family Medicine Physician
- Danville, PA
- NPI 1366493868
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Geriatric Medicine (Internal Medicine) Physician
- Staten Island, NY
- NPI 1417901323
-
- Urology Physician
- Lewisburg, PA
- NPI 1083412084
-
- Clinical Psychologist
- Lewisburg, PA
- NPI 1720187370
-
- Diagnostic Radiology Physician
- Danville, PA
- NPI 1558313023
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- Anesthesiology Physician
- Bay Shore, NY
- NPI 1023513116
-
- Hospitalist Physician
- Wilkes Barre, PA
- NPI 1588614358
-
- General Acute Care Hospital
- Wilkes Barre, PA
- NPI 1275620585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613001600000",
"number": "1164417879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-271-6144",
"fax_number": "570-271-6578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E MOUNTAIN BLVD",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187110027",
"telephone_number": "570-808-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENKATARAMAN",
"first_name": "AKILA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-19",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": "NY",
"license": "001613",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "PA",
"license": "MD471964",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02350567",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "2603656",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE",
"identifier": "0100559",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2196604 04",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "7863378",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLAN",
"identifier": "P2640917",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "127400101",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH FIRST",
"identifier": "001613-A15",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS",
"identifier": "501Z91",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AFFINITY HEALTH",
"identifier": "1000028191",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA USHC HMO",
"identifier": "2969639",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "4C2294",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "avenkataraman312129@direct.geisinger.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1000 E Mountain Blvd",
"city": "Wilkes Barre",
"state": "PA",
"country_code": "US",
"postal_code": "187110027",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.