Individual provider Active NPI

Latha Chandran, M.D., M.P.H.

  • Pediatrics Physician
  • East Setauket, NY
National Provider Identifier
1407894397
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
186838 Issued in NY
Practice address
4 Technology Dr
East Setauket, NY 11733-4080
Phone
(631) 444-4601
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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 186838 NY Primary

Addresses

Primary practice location

4 Technology Dr
East Setauket, NY 11733-4080

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-0650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200810000327 FL Practitioner - Pediatric Medicine 9234132861 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Jun 5, 2020 Accepting new patients
University of Miami Current Accepting new patients
University of Miami Pediatrics CurrentSince Jun 5, 2020 Accepting new patients

Locations

1601 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4029

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

Organizations & group practices 3

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1407894397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334080",
            "telephone_number": "631-444-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRAN",
        "first_name": "LATHA",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "186838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.