Individual provider Active NPI

Preethi Padmanaban, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1255746046
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
259716 Issued in MA
Practice address
736 Cambridge St
Boston, MA 02135-2907
Phone
(617) 779-6342
NPI assigned
Jun 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 259716 MA Primary

Addresses

Primary practice location

736 Cambridge St
Boston, MA 02135-2907

Mailing address

92 Gordon St Apt 404
Brighton, MA 02135-6219
Phone (770) 309-9840

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ppadmanaban@hamilton.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, DC2 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
I20200918001304 GA Practitioner - Hospitalist 7517258460 Reassigns benefits to 1 organization
I20260520004661 DC Practitioner - Endocrinology 7517258460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton Medical Center, IncGroup PAC ID 0446151179, 105 clinicians

Practice addresses (Care Compare)

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Oct 1, 2020 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Oct 1, 2020 Accepting new patients

Locations

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

Interoperability endpoints

  • Direct secure messaging: ppadmanaban19149@hhcs.direct-ci.com
  • Direct secure messaging: ppadmanaban@hamilton.cernerdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1616457600000",
    "number": "1255746046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 GORDON ST APT 404",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021356219",
            "telephone_number": "770-309-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-779-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADMANABAN",
        "first_name": "PREETHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "259716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppadmanaban@hamilton.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDDA",
            "address_1": "1200 Memorial Dr",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307202529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.