Individual provider Active NPI

Madhavi Prabhakar Kapoor, M.D.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1467795518
Registry record updated Apr 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
88863 Issued in GA
Practice address
160 Varick St FL 6
New York, NY 10013-1272
Phone
(212) 457-1790
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 284779 NY
Pediatrics Physician 208000000X 88863 GA Primary

Addresses

Primary practice location

160 Varick St FL 6
New York, NY 10013-1272

Mailing address

2870 Peachtree Rd NW # 915-2603
Atlanta, GA 30305-2918

Other names 1

  • Madhavi Sai Prabhakar Other name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161029000403 NY Practitioner - Pediatric Medicine 1355629155 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284779NYMDLicensed Practical Nurse
88863GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Nov 1, 2016 Accepting new patients
New York University Pediatrics CurrentSince Nov 1, 2016 Accepting new patients

Locations

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648857600000",
    "number": "1467795518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 PEACHTREE RD NW # 915-2603",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 VARICK ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131272",
            "telephone_number": "212-457-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPOOR",
        "first_name": "MADHAVI",
        "middle_name": "PRABHAKAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2022-04-02",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "284779",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "88863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADHAVI",
            "last_name": "PRABHAKAR",
            "middle_name": "SAI",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.