Active NPI
Jai P Naidu IV, MD
- Pediatrics Physician
- Towanda, PA
National Provider Identifier
1669664447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD037174L
- Practice address
- 37 Pratt Ave
Towanda, PA 18848 - Phone
- (570) 268-2594
- Fax
- (570) 265-2328
- NPI assigned
- Aug 15, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD037174L | PA | Primary |
Addresses
Primary practice location
37 Pratt Ave
Towanda, PA 18848
Mailing address
91 Hospital Dr
Towanda, PA 18848-9702
Phone (570) 268-2594
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 |
|---|---|---|---|
| MD037174L | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321574400000",
"number": "1669664447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 HOSPITAL DR",
"city": "TOWANDA",
"state": "PA",
"postal_code": "188489702",
"telephone_number": "570-268-2594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 PRATT AVE",
"city": "TOWANDA",
"state": "PA",
"postal_code": "18848",
"telephone_number": "570-268-2594",
"fax_number": "570-265-2328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAIDU",
"first_name": "JAI",
"middle_name": "P",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-15",
"last_updated": "2011-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD037174L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Towanda, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.