NPIMap

Individual provider Active NPI

Praveen Rudraraju, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Mount Kisco, NY
National Provider Identifier
1285802694
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
247554 Issued in NY
Practice address
400 East Main Street
Northern Westchester Hospital, Critical Care
Mount Kisco, NY 10549
Phone
(914) 666-1200
Fax
(914) 666-1978
NPI assigned
Feb 19, 2008
Last updated
Feb 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 247554 NY Primary
Pulmonary Disease Physician 207RP1001X 247554 NY

Addresses

Primary practice location

400 East Main Street
Northern Westchester Hospital, Critical Care
Mount Kisco, NY 10549

Mailing address

400 East Main Street - Northern Westchester Hospital
Medical Affairs Office
Mt. Kisco, NY 10549
Phone (914) 666-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080626000698 NY Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 7214009885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients
Northern Westchester Hospital Association CurrentSince Jul 1, 2008 Accepting new patients
Northern Westchester Hospital Association Critical Care Medicine CurrentSince Jul 1, 2008 Accepting new patients
Northern Westchester Hospital Association Current Accepting new patients
True North Medical Group PC Past Accepting new patients

Locations

480 Bedford Rd
Chappaqua, NY 10514
Phone (866) 997-5781

480 Bedford Rd
Bldg C
Chappaqua, NY 10514
Phone (914) 559-5060

300 Community Dr
Manhasset, NY 11030

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

400 E Main St
Ofc
Mount Kisco, NY 10549
Phone (914) 242-8318

Networks

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

Interoperability endpoints

  • Direct secure messaging: prudraraju27836@northwell.direct-ci.com

Organizations & group practices 5

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 4

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": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1285802694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST MAIN STREET - NORTHERN WESTCHESTER HOSPITAL",
            "address_2": "MEDICAL AFFAIRS OFFICE",
            "city": "MT. KISCO",
            "state": "NY",
            "postal_code": "10549",
            "telephone_number": "914-666-1200",
            "fax_number": "914-666-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST MAIN STREET",
            "address_2": "NORTHERN WESTCHESTER HOSPITAL, CRITICAL CARE",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "10549",
            "telephone_number": "914-666-1200",
            "fax_number": "914-666-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDRARAJU",
        "first_name": "PRAVEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "247554",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "247554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.