Active NPI
Pardha S Valluru, MD
- Rehabilitation Practitioner
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- 203580
- Practice address
- 2601 Ocean Pkwy
Brooklyn, NY 11235-7745 - Phone
- (718) 616-4408
- Fax
- (718) 616-4105
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 203580 | NY | Primary |
Addresses
Primary practice location
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Mailing address
3720 77TH St
2ND Floor
Jackson Heights, NY 11372-6630
Phone (718) 505-1952
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01756032 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356
Hospital & facility affiliations
- South Brooklyn Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 203580 | NY | MD | Rehabilitation Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Affiliate Group of New York PC | Current | Accepting new patients | |
| Coney Island Medical Practice Plan, P.C. | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Past | Accepting new patients | |
| University Group Medical Associates, P.C | Past | Accepting new patients |
Locations
2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- pvalluru147536@nychhc.direct-ci.com
Organizations & group practices 4
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.
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- General Practice Physician
- Brooklyn, NY
- NPI 1386951762
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1679587679
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1285683102
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1124032982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497773303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3720 77TH ST",
"address_2": "2ND FLOOR",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113726630",
"telephone_number": "718-505-1952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 OCEAN PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112357745",
"telephone_number": "718-616-4408",
"fax_number": "718-616-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLURU",
"first_name": "PARDHA",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NY",
"license": "203580",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01756032",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
- Valley Stream Diagnostic Medicine P.C.
- Valley Stream Medical of New York, LLC
- Valley Stream Occupational Therapy P.C
- Agathi Vallianatos, M.D.
- Catherine Vallone, MS, CCC-SLP
- Geraldine Merry Valme-Daleus, FNP-BC
- Gerald Valme, M.D.
- Widad Artagrace Valme, OD
- Robert Valmont, PHARMD, MPH
- Marie Juna Valmus
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.