Mini Pradeep

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209008767 Issued in IL

Practice address

1032 E Ogden Ave
Naperville, IL 60563-8618

Phone

(630) 705-1208

NPI assigned

Jun 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mini Jacob Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpradeeprn27643@direct.utmb.edu

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.

• Utmb Faculty Group Practice

  • General Practice Physician
  • Galveston, TX
  • NPI 1942241146
  Medicare reassignment Care Compare group NPD
• Metropolitan Family Care

  • Voluntary or Charitable Agency
  • Naperville, IL
  • NPI 1154631968
  NPD (past)
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  NPD (past)
• Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1114139946

  Adult Health

  NPD (past)
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700
  NPD (past)
• University of Texas Medical Branch at Galveston

  • Community/Retail Pharmacy
  • Friendswood, TX
  • NPI 1699532861
  NPD (past)

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

• University of Texas Medical Branch at Galveston

  • General Acute Care Hospital
  • Galveston, TX
  • NPI 1548226988
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1275820227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 CRAB TREE DR",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605593480",
            "telephone_number": "630-963-9412",
            "fax_number": "630-963-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 E OGDEN AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638618",
            "telephone_number": "630-705-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADEEP",
        "first_name": "MINI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209008767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINI",
            "last_name": "JACOB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Powell, R.O.T.
• Powerback Rehabilitation LLC
• Michaela Powers
• Allison Pozzi
• Angela Teresa Pozzi, LCPC
• Paola Prado
• Susan Pragaspathy, LPC
• Prairie Path Speech Therapy
• Prairie Path Speech Therapy, Inc
• Prasad Gonavarum D.D.S., P.C.

• Adult Health Nurse Practitioner in Naperville, IL
• Providers in Naperville, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.