Individual provider Active NPI

Pratyusha Reddy Katta, MD

  • Hospitalist Physician
  • Mount Holly, NJ
National Provider Identifier
1699013045
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
25MA09342900 Issued in NJ
Practice address
175 Madison Ave
Mount Holly, NJ 08060-2099
Phone
(609) 914-6000
NPI assigned
Jan 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD452969 PA
Hospitalist Physician 208M00000X 25MA09342900 NJ Primary

Addresses

Primary practice location

175 Madison Ave
Mount Holly, NJ 08060-2099

Mailing address

8 Madeira CT
Moorestown, NJ 08057-3144
Phone (732) 857-7742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20171019001539 NJ Practitioner - General Practice 7618243668 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD452969PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childens Health Care Associates of New Jersey PC CurrentSince Feb 14, 2023 Accepting new patients
Childrens Health Care Associates of New Jersey PC Current Accepting new patients
Nemours New Jersey Physician Practice, P.C. CurrentSince Aug 15, 2017 Accepting new patients
Children'S Healthcare Associates of New Jersey PC CurrentSince Feb 14, 2023 Accepting new patients
Virtua - West Jersey Health System, Inc. Past Accepting new patients
Virtua - Memorial Hospital Burlington County, Inc. Past Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

1280 Almonesson Rd
Woodbury, NJ 08096
Phone (856) 345-1401

3401 Civic Center Blvd
#M975
Philadelphia, PA 19104

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1699013045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MADEIRA CT",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573144",
            "telephone_number": "732-857-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVE",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602099",
            "telephone_number": "609-914-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATTA",
        "first_name": "PRATYUSHA",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-18",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD452969",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA09342900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

Verify at the official NPI Registry.