Active NPI
Venkateswara Rao Nadella, MD
- Family Medicine Physician
- Bradford, PA
National Provider Identifier
1366494536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD037767L
- Practice address
- 6 North Center Street
Bradford, PA 16701 - Phone
- (814) 368-7000
- Fax
- (814) 362-6243
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD037767L | PA | Primary |
Addresses
Primary practice location
6 North Center Street
Bradford, PA 16701
Mailing address
6 North Center St
Bradford, PA 16701
Phone (814) 368-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000771889 | Medicaid | PA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri- County Diagnostic Testing Services LLC | Past | 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.
-
- Clinic/Center
- Bradford, PA
- NPI 1437245784
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226966400000",
"number": "1366494536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 NORTH CENTER ST",
"city": "BRADFORD",
"state": "PA",
"postal_code": "16701",
"telephone_number": "814-368-7000",
"fax_number": "814-362-6243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 NORTH CENTER STREET",
"city": "BRADFORD",
"state": "PA",
"postal_code": "16701",
"telephone_number": "814-368-7000",
"fax_number": "814-362-6243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NADELLA",
"first_name": "VENKATESWARA",
"middle_name": "RAO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2008-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD037767L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000771889",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bradford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.