Individual provider Active NPI

Prasuna R Nukalapati

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1497744841
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
127129 Issued in NY
Practice address
4673 Park Ave
Bronx, NY 10458-5623
Phone
(718) 365-5413
Fax
(718) 364-6716
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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 127129 NY Primary

Addresses

Primary practice location

4673 Park Ave
Bronx, NY 10458-5623

Mailing address

4673 Park Ave
Bronx, NY 10458-5623
Phone (718) 365-5413

Other identifiers 1

IdentifierTypeStateIssuer
00237009MedicaidNY

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
I20110203001044 NY Practitioner - Pediatric MedicinePractitioner - General Practice 4183804438 Practice locations: Bronx, NY

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: General Practice
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4673 Park Ave
Bronx, NY 10458-5606
Phone (718) 365-5413

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
127129NYMDPediatrics Physician

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: prasuna.nukalapati@prasunarnukalapatimd.ehi.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1497744841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4673 PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585623",
            "telephone_number": "718-365-5413",
            "fax_number": "718-364-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4673 PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585623",
            "telephone_number": "718-365-5413",
            "fax_number": "718-364-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUKALAPATI",
        "first_name": "PRASUNA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "127129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00237009",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.