NPIMap

Individual provider Active NPI

Chetana Ravindra Pendkar, M.B.B.S.

  • Critical Care Medicine (Internal Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1629525175
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
76576-20 Issued in WI
Practice address
4802 10TH Ave
Maimonides Medical Center
Brooklyn, NY 11219
Phone
(718) 283-6000
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X 76576-20 WI Primary

Addresses

Primary practice location

4802 10TH Ave
Maimonides Medical Center
Brooklyn, NY 11219

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220801000643 WI Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 6103161187 Reassigns benefits to 2 organizations
I20250929001144 WA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6103161187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Lilly Rd NE
Suite 204
Olympia, WA 98506-5197
Phone (360) 413-8272

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Multi-Specialty Current Accepting new patients
Bellin Memorial Hospital Inc Multi-Specialty CurrentSince Jul 18, 2022 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 11, 2025 Accepting new patients
Oconto Hospital & Medical Center Inc Multi-Specialty CurrentSince Jul 18, 2022 Accepting new patients
Providence Health & Services Washington Multi-Specialty CurrentSince Aug 11, 2025 Accepting new patients
Oconto Hospital & Medical Center Inc Multi-Specialty Current Accepting new patients
Oconto Hospital & Medical Center Inc Multi-Specialty CurrentSince Jul 18, 2022 Accepting new patients
Bellin Memorial Hospital Inc Multi-Specialty CurrentSince Jul 18, 2022 Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

1018 Capitol Way S
Ste 300
Olympia, WA 98501
Phone (360) 486-6508

500 Lilly Rd NE
Ste 204
Olympia, WA 98506
Phone (360) 413-8191

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: cpendkar4018262@wm.providencedirect.org

Organizations & group practices 9

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 10

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1629525175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "address_2": "MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDKAR",
        "first_name": "CHETANA",
        "middle_name": "RAVINDRA",
        "credential": "M.B.B.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WI",
            "license": "76576-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.