Individual provider Active NPI

Praveena Madapathi, MD

  • Hospitalist Physician
  • Parkersburg, WV
National Provider Identifier
1205462330
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
M-2407 Issued in GU
Practice address
800 Garfield Ave RM G-102
Parkersburg, WV 26101-5376
Phone
(304) 424-4575
Fax
(304) 424-4577
NPI assigned
Mar 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WV
Hospitalist Physician 208M00000X M-2407 GU Primary

Addresses

Primary practice location

800 Garfield Ave RM G-102
Parkersburg, WV 26101-5376

Mailing address

800 Garfield Ave RM G-102
Parkersburg, WV 26101-5376
Phone (304) 424-4575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20231220000310 GU Practitioner - Internal Medicine 2567812365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.22 of 100Reported as group
Quality
78.84
Improvement activities
40
Cost
61.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-2407GUMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Healthcare Development Incorporated CurrentSince Nov 27, 2023 Accepting new patients
Camden Clark Memorial Hospital Corporation PastSince Mar 22, 2020 Accepting new patients
Camden-Clark Physician Corporation PastSince Mar 22, 2020 Accepting new patients
Guam Healthcare Development Incorporated Past Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

Organizations & group practices 4

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1205462330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GARFIELD AVE RM G-102",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015376",
            "telephone_number": "304-424-4575",
            "fax_number": "304-424-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GARFIELD AVE RM G-102",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015376",
            "telephone_number": "304-424-4575",
            "fax_number": "304-424-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADAPATHI",
        "first_name": "PRAVEENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GU",
            "license": "M-2407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.