Individual provider Active NPI

Padmanabh U Paddu, MD

  • Gastroenterology Physician
  • Woodside, NY
National Provider Identifier
1497797708
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
135522 Issued in NY
Practice address
4902 Queens Blvd
Lower Level
Woodside, NY 11377-4444
Phone
(718) 784-4502
Fax
(718) 784-5180
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 135522 NY Primary

Addresses

Primary practice location

4902 Queens Blvd
Lower Level
Woodside, NY 11377-4444

Mailing address

4902 Queens Blvd Lowr Level
Woodside, NY 11377-4444
Phone (718) 784-4502

Other practice location 1

8221 Baxter Ave
Elmhurst, NY 11373-1350
Phone (718) 784-4502

Other names 1

  • Padmanabh U Paddu Professional 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
I20050415000596 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 2961449467 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

4902 Queens Blvd
Woodside, NY 11377-4444
Phone (718) 784-4502

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Hospital CurrentSince Jul 1, 2004 Accepting new patients
Paddu & Associates Medical LLP Gastroenterology CurrentSince Sep 19, 2007 Accepting new patients
The Mount Sinai Hospital CurrentSince Jul 1, 2004 Accepting new patients
Boro Medical, P.C. Gastroenterology Past Accepting new patients
North Shore-Lij Medical PC Past Accepting new patients
Booth Medical Associates PC Gastroenterology Past Accepting new patients
Boro Medical, P.C. Gastroenterology Past Accepting new patients
Jeffrey Schneller DPM PC PastSince Aug 1, 2012 Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

2715 30th Ave
Long Island City, NY 11102
Phone (718) 267-4808

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

4902 Queens Blvd
Lowr
Woodside, NY 11377
Phone (718) 729-1952

4902 Queens Blvd
Ste 2
Woodside, NY 11377
Phone (929) 296-6790

4902 Queens Blvd
Woodside, NY 11377
Phone (718) 205-0550

Networks

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

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1497797708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 QUEENS BLVD LOWR LEVEL",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774444",
            "telephone_number": "718-784-4502",
            "fax_number": "718-784-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 QUEENS BLVD",
            "address_2": "LOWER LEVEL",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774444",
            "telephone_number": "718-784-4502",
            "fax_number": "718-784-5180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8221 Baxter Ave",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731350",
            "country_code": "US",
            "telephone_number": "718-784-4502",
            "fax_number": "718-784-5180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADDU",
        "first_name": "PADMANABH",
        "middle_name": "U",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "135522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PADMANABH",
            "last_name": "PADDU",
            "middle_name": "U",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.