Preethi K Naidu, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

011094 Issued in NY

Practice address

3505 Veterans Memorial Hwy Ste C
Ronkonkoma, NY 11779-7613

Phone

(631) 676-7656

Fax

(631) 676-7648

NPI assigned

Jun 4, 2007

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 identifiers 1

Other names 1

• Ms. Preethi K Naidu Other name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: preethinaidu@nslijmedgr.allscriptsdirect.net

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.

• Preferred Professional Medical Care PC

  • Internal Medicine Physician
  • Ronkonkoma, NY
  • NPI 1083916670
  Medicare reassignment

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1336341023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 VETERANS MEMORIAL HWY STE C",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797613",
            "telephone_number": "631-676-7656",
            "fax_number": "631-676-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 VETERANS MEMORIAL HWY STE C",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797613",
            "telephone_number": "631-676-7656",
            "fax_number": "631-676-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "PREETHI",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PREETHI",
            "last_name": "NAIDU",
            "middle_name": "K",
            "prefix": "MS.",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Judith Fern Murphy, RN
• Nina A Murphy, PSYD
• Tracy Elizabeth Murphy, MS ED
• John Charles Mutziger Jr.
• Karlyn Taylor Nafey, RPA-C
• Dominick Joseph Napolitano
• National Medtrans Network Inc.
• Nicole Natoli, M.A.
• Brian Neal, D.O.
• Neil's Pharmacy Inc.

• Medical Physician Assistant in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.