Individual provider Active NPI

Siva Venkat, MD FRCSC

  • Urology Physician
  • New York, NY
National Provider Identifier
1336739259
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
17802 Issued in ZZ
Practice address
525 East 68TH Street, Starr 9
New York, NY 10065-1006
Phone
(646) 962-9600
Fax
(646) 962-0715
NPI assigned
Jan 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X 17802 ZZ Primary

Addresses

Primary practice location

525 East 68TH Street, Starr 9
New York, NY 10065-1006

Mailing address

525 East 68TH Street, Starr 9
New York, NY 10065-5347
Phone (646) 508-0734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17802ZZMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Cornell University Medical College PastSince Jan 31, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1336739259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 EAST 68TH STREET, STARR 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100655347",
            "telephone_number": "646-508-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 EAST 68TH STREET, STARR 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100651006",
            "telephone_number": "646-962-9600",
            "fax_number": "646-962-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKAT",
        "first_name": "SIVA",
        "credential": "MD FRCSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ZZ",
            "license": "17802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.