Krishna Prasad Madiraju, M.D.FAAP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101054958 Issued in VA

Practice address

2024 Opitz Blvd Ste a
Woodbridge, VA 22191-3388

Phone

(703) 492-7000

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Century Pediatrics, Inc

  • Physician Assistant
  • Stafford, VA
  • NPI 1649666728
  NPD (past) Authorized official
• Century Pediatrics Inc.

  • Pediatrics Physician
  • Woodbridge, VA
  • NPI 1558428953
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1376600759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22445 CONSERVANCY DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201488068",
            "telephone_number": "703-899-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 OPITZ BLVD STE A",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913388",
            "telephone_number": "703-492-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADIRAJU",
        "first_name": "KRISHNA",
        "middle_name": "PRASAD",
        "name_prefix": "Dr.",
        "credential": "M.D.FAAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101054958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010236568",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5686693",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE PPO",
            "identifier": "897801",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006720421",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006739491",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259327",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368437",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "98446",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• M.a.K. Superior Home Health LLC
• M. Bernadette Macdonald, APRN-PMH
• Priscilla Maclomotey
• Kayla C. Macri, D.M.D.
• Tiffany Maddox, SPECIALIST
• Ingrid Madison, LGSW
• Magnus Heart and Vascular, Inc.
• Laura Mahabir
• Kathleen Kearney Mahar, PH. D., LCSW
• Yasir Mahboba

• Pediatrics Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.