Active NPI
Nagendra Nadaraja, M.D.
- Surgery Physician
- Rochester, NY
National Provider Identifier
1497747737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 123182-1
- Practice address
- 1561 Long Pond Rd
Suite 107
Rochester, NY 14626-4117 - Phone
- (585) 723-7281
- Fax
- (585) 723-8660
- NPI assigned
- Aug 22, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 123182-1 | NY | Primary |
Addresses
Primary practice location
1561 Long Pond Rd
Suite 107
Rochester, NY 14626-4117
Mailing address
1561 Long Pond Rd
Suite 107
Rochester, NY 14626-4117
Phone (585) 723-7281
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00433858 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123182-1 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Unity Hospital of Rochester | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1457395766
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352246400000",
"number": "1497747737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1561 LONG POND RD",
"address_2": "SUITE 107",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146264117",
"telephone_number": "585-723-7281",
"fax_number": "585-723-8660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1561 LONG POND RD",
"address_2": "SUITE 107",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146264117",
"telephone_number": "585-723-7281",
"fax_number": "585-723-8660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NADARAJA",
"first_name": "NAGENDRA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2012-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "123182-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00433858",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- 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.