Prateek Patibandla, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

U6316 Issued in TX

Practice address

475 Seaview Avenue
Staten Island, NY 10305

Phone

(718) 226-6205

Fax

(718) 226-8695

NPI assigned

May 2, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, TX, GA3 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 3

Specialty

Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Physician Services - Southeast Professional CorporationGroup PAC ID 5597774554, 825 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Doctors Hospital Hospital, Augusta, GA, CCN 110177

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppatibandla335559@christushealth.direct-ci.net

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 Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385
  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  Internal Medicine

  Medicare reassignment NPD
• North Texas Physician Services, PLLC

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1992586150
  Medicare reassignment NPD
• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470

  Internal Medicine

  NPD
• Tower Health Medical Group

  dba Addiction Medicine - Tower Health Medical Group

  • Addiction Medicine (Family Medicine) Physician
  • Reading, PA
  • NPI 1093266140
  NPD
• Tower Health Medical Group

  dba Internal Medicine - Tower Health Medical Group

  • Internal Medicine Physician
  • Birdsboro, PA
  • NPI 1609291350
  NPD
• Tower Health Medical Group

  dba Breast Health Center Wyomissing Tower Health Medical Group

  • Surgery Physician
  • Wyomissing, PA
  • NPI 1831954353
  NPD
• Doctors Hospital of Augusta LLC

  dba Doctors Hospital (Augusta)

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1912951963
  NPD (past)

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

• Doctors Hospital of Augusta LLC

  dba Doctors Hospital (Augusta)

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1912951963
  Care Compare affiliation

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1326493958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-6205",
            "fax_number": "718-226-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-6205",
            "fax_number": "718-226-8695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015580",
            "country_code": "US",
            "telephone_number": "903-315-1488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "TX",
            "postal_code": "756705336",
            "country_code": "US",
            "telephone_number": "903-315-1488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATIBANDLA",
        "first_name": "PRATEEK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "U6316",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U6316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pathmark Stores, Inc. (Pathmark Pharmacy # 171)
• Pathways of Hope LCSW's
• Michyl Patigdas
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• Yury Patin II
• Patricia Nicoletta
• Patrick Mele Psychological Services

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.