Active NPI
Padmaja Yalavarti, M.D
- Psychiatry Physician
- Staten Island, NY
National Provider Identifier
1356509632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 264286-1
- Practice address
- 777 Seaview Ave
Staten Island, NY 10305 - Phone
- (718) 667-2820
- NPI assigned
- May 23, 2008
- Last updated
- Aug 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 264286-1 | NY | Primary |
Addresses
Primary practice location
777 Seaview Ave
Staten Island, NY 10305
Mailing address
777 Seaview Ave
Staten Island, NY 10305
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170524000210 | NY | Order and Referring Only - Psychiatry | 2860769817 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 264286-1 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344384000000",
"number": "1356509632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10305",
"telephone_number": "718-667-2820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YALAVARTI",
"first_name": "PADMAJA",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-23",
"last_updated": "2012-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "264286-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.