NPIMap

Individual provider Active NPI

Prathibha Potharlanka, M.D.

  • Hospitalist Physician
  • Willingboro, NJ
National Provider Identifier
1295761690
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
25MA07690100 Issued in NJ
Practice address
218 Sunset Rd
Willingboro, NJ 08046-1110
Phone
(609) 835-2900
Fax
(856) 566-2797
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07690100 NJ
Hospitalist Physician 208M00000X 25MA07690100 NJ Primary

Addresses

Primary practice location

218 Sunset Rd
Willingboro, NJ 08046-1110

Mailing address

30 Belmont Cir
Columbus, NJ 08022-9714
Phone (609) 789-0800

Other identifiers 4

IdentifierTypeStateIssuer
0078875MedicaidNJ
0033120MedicaidNJ
7221574OtherNJAETNA PPO
P00603546-MERCEROtherNJRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20041004000017 NJ Practitioner - Internal Medicine 4587633862 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sai Inpatient Resources, LLCGroup PAC ID 2668492711, 29 clinicians
Cooper Physician Offices PAGroup PAC ID 2860396611, 326 clinicians

Practice addresses (Care Compare)

1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone (609) 945-5724

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-3000

30 Belmont Cir
Columbus, NJ 08022-9714
Phone (609) 438-8070

Hospital & facility affiliations

  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07690100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prathibha Potharlanka LLC CurrentSince Jun 1, 2024 Accepting new patients
Vcare Urgent Care LLC CurrentSince Aug 5, 2022 Accepting new patients
Sai Inpatient Resources, LLC Internal Medicine CurrentSince Jun 1, 2017 Accepting new patients
Clinical Staffing Solutions P.C. Internal Medicine Past Accepting new patients
Executive Health Resources Clinical Staffing Solutions PC Internal Medicine Past Accepting new patients
Stellar Medical Group Internal Medicine Past Accepting new patients
Hemcare Medical Clinic, PC Past Accepting new patients
Moorestown Internal Medicine, P.C. Internal Medicine PastSince Sep 7, 1990 Accepting new patients
Hera Inpatient Services Internal Medicine Past Accepting new patients

Locations

1 3rd St
Bordentown, NJ 08505
Phone (609) 298-2005

485 Georges Rd
Ste 114
Dayton, NJ 08810
Phone (856) 465-7728

8 Centre Dr
Monroe Twp, NJ 08831
Phone (609) 252-8760

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

253 Witherspoon St
Princeton, NJ 08540
Phone (609) 497-4000

Interoperability endpoints

  • Direct secure messaging: prathibha.potharlanka@520652229640196.direct.elationemr.com

Organizations & group practices 10

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 2

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1295761690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BELMONT CIR",
            "city": "COLUMBUS",
            "state": "NJ",
            "postal_code": "080229714",
            "telephone_number": "609-789-0800",
            "fax_number": "609-298-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 SUNSET RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461110",
            "telephone_number": "609-835-2900",
            "fax_number": "856-566-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHARLANKA",
        "first_name": "PRATHIBHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07690100",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA07690100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078875",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0033120",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7221574",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00603546-MERCER",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

Verify at the official NPI Registry.