Individual provider Active NPI

Padmini Nallapaneni, MD

  • Pediatric Gastroenterology Physician
  • New York, NY
National Provider Identifier
1174055503
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
304644 Issued in NY
Practice address
3959 Broadway
New York, NY 10032-1559
Phone
(212) 305-5903
Fax
(212) 342-5756
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 15

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.

View all 15

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Columbia University in the City of New York 2,262 clinicians

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230831004408 NY Practitioner - Pediatric Medicine 8426392226 Reassigns benefits to 2 organizations
I20260505004436 NJ Practitioner - Pediatric Medicine 8426392226 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
304644NYMDPediatric Gastroenterology Physician

Practice roles (5 of 9)

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2023 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Dec 7, 2024 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology PastSince Apr 20, 2026 Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

1111 Westchester Ave
White Plains, NY 10604
Phone (212) 305-1021

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 304644 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

3959 Broadway
New York, NY 10032-1559

Mailing address

3959 Broadway
New York, NY 10032-1559
Phone (212) 305-5903

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 3, 2023.

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1174055503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-5903",
            "fax_number": "212-342-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-5903",
            "fax_number": "212-342-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLAPANENI",
        "first_name": "PADMINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "304644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.