Individual provider Active NPI

Praveena Vendoti Dhawale, MD

  • Pediatrics Physician
  • Westerville, OH
National Provider Identifier
1356371173
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.082260 Issued in OH
Practice address
625 Africa Rd Ste 300
Westerville, OH 43082-9830
Phone
(614) 882-9460
Fax
(614) 882-9802
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.082260 OH Primary

Addresses

Primary practice location

625 Africa Rd Ste 300
Westerville, OH 43082-9830

Mailing address

625 Africa Rd Ste 300
Westerville, OH 43082-9830
Phone (614) 882-9460

Other identifiers 1

IdentifierTypeStateIssuer
2482853MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20181105001189 OH Practitioner - Pediatric Medicine 5799038907 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.082260OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients

Locations

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: pdhawale19136@copcp.medicity.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1356371173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 AFRICA RD STE 300",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430829830",
            "telephone_number": "614-882-9460",
            "fax_number": "614-882-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 AFRICA RD STE 300",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430829830",
            "telephone_number": "614-882-9460",
            "fax_number": "614-882-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHAWALE",
        "first_name": "PRAVEENA",
        "middle_name": "VENDOTI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.082260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2482853",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.