Venkateswara Rao Inaganti, M.D

Key facts

NPI

1366522153

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatry Physician 2084P0800X

License

170115 (NY)

Practice address

69 Old Temple Hill Road
Vails Gate, NY 12584

Phone

(845) 565-7805

Fax

(845) 838-2956

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366522153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 JEFFERSON ST",
            "city": "HIGHLAND MILLS",
            "state": "NY",
            "postal_code": "109302724",
            "telephone_number": "845-928-9607",
            "fax_number": "845-838-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 OLD TEMPLE HILL ROAD",
            "city": "VAILS GATE",
            "state": "NY",
            "postal_code": "12584",
            "telephone_number": "845-565-7805",
            "fax_number": "845-838-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INAGANTI",
        "first_name": "VENKATESWARA",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "170115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01251096",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Vails Gate, NY · Psychiatry Physician in New York