Individual provider Active NPI

Lourdu Sireesha Pentareddy, MD

  • Internal Medicine Physician
  • New Rochelle, NY
National Provider Identifier
1336600014
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD478602 Issued in PA
Practice address
16 Guion PL
New Rochelle, NY 10801-5502
Phone
(914) 365-3680
Fax
(914) 365-5489
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD478602 PA Primary

Addresses

Primary practice location

16 Guion PL
New Rochelle, NY 10801-5502

Mailing address

16 Guion PL
New Rochelle, NY 10801-5502
Phone (914) 365-3680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220830002501 PA Practitioner - Internal Medicine 9335523059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 E Olney Ave
Philadelphia, PA 19120-2470
Phone (215) 927-1937

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Community Health Associates, Inc Internal Medicine CurrentSince Dec 15, 2024 Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Dec 15, 2024 Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

118 Welsh Rd
Horsham, PA 19044
Phone (215) 366-1160

500 York Rd
Ste 203
Jenkintown, PA 19046
Phone (215) 886-0174

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

Organizations & group practices 2

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 8

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1336600014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 GUION PL",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015502",
            "telephone_number": "914-365-3680",
            "fax_number": "914-365-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 GUION PL",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015502",
            "telephone_number": "914-365-3680",
            "fax_number": "914-365-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTAREDDY",
        "first_name": "LOURDU SIREESHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD478602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.