NPIMap

Individual provider Active NPI

Padmaja Jonnalagadda, MD

  • Nuclear Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1265442925
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
License
MD429986 Issued in PA
Practice address
3401 N Broad Street
Philadelphia, PA 19140-1702
Phone
(215) 707-7237
Fax
(217) 707-7237
NPI assigned
Aug 8, 2006
Last updated
Sep 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35.088719 OH
Nuclear Radiology Physician 2085N0904X MD429986 PA Primary

Addresses

Primary practice location

3401 N Broad Street
Philadelphia, PA 19140-1702

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-7237

Other practice location 1

333 Cottman Ave
Philadelphia, PA 19111-2497
Phone (215) 728-3883

Other identifiers 3

IdentifierTypeStateIssuer
P00396884OtherOHRAILROAD MEDICARE
2760892MedicaidOH
P00423243OtherOHRAILROAD MEDICARE

Other names 1

  • Padmaja Athota Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080728000125 PA Practitioner - Diagnostic Radiology 3870591837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD429986PAMDNuclear Radiology Physician
35.088719OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc CurrentSince Mar 6, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 6, 2019 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients

Locations

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

11000 Roosevelt Blvd
Philadelphia, PA 19116
Phone (215) 214-6655

2301 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 282-8000

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1265442925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-7237",
            "fax_number": "215-707-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191401702",
            "telephone_number": "215-707-7237",
            "fax_number": "217-707-7237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Cottman Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112497",
            "country_code": "US",
            "telephone_number": "215-728-3883",
            "fax_number": "215-728-1185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONNALAGADDA",
        "first_name": "PADMAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.088719",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "MD429986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00396884",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2760892",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00423243",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PADMAJA",
            "last_name": "ATHOTA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.