Organization Active NPI

Rajendra Pradhan, M. D. P.C.

  • Nephrology Physician
  • New York, NY
National Provider Identifier
1477732048
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
114439 Issued in NY
Legal business name
RAJENDRA PRADHAN, M. D. P.C.
Practice address
247 3Rd Ave
Suite 503
New York, NY 10010-7457
Phone
(212) 982-0600
NPI assigned
Oct 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Authorized official

Name
Dr. Rajendra Prasad Pradhan, MD
Title
President
Phone
(212) 982-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 114439 NY Primary

Addresses

Primary practice location

247 3Rd Ave
Suite 503
New York, NY 10010-7457

Mailing address

372 Central Park West
12G
New York, NY 10025-8240
Phone (212) 982-0600

Other identifiers 1

IdentifierTypeStateIssuer
00209494MedicaidNY

National Provider Directory

National Provider Directory

Locations

347 3rd Ave
Ste 503
New York, NY 10010
Phone (212) 982-0600

247 3rd Ave
Rm 503
New York, NY 10010
Phone (212) 982-4100

193 3rd Ave
New York, NY 10003
Phone (212) 388-0095

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1477732048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 CENTRAL PARK WEST",
            "address_2": "12G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100258240",
            "telephone_number": "212-982-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 3RD AVE",
            "address_2": "SUITE 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100107457",
            "telephone_number": "212-982-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJENDRA PRADHAN, M. D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "PRADHAN",
        "authorized_official_first_name": "RAJENDRA",
        "authorized_official_middle_name": "PRASAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-982-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "114439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00209494",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.