NPIMap

Organization Active NPI

Manhattan Medical Practice PC

  • Anesthesiology Physician
  • Smithtown, NY
National Provider Identifier
1699922294
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
232151 Issued in NY
Legal business name
MANHATTAN MEDICAL PRACTICE PC
Practice address
989 W Jericho Tpke Ste 1
Smithtown, NY 11787-3241
Phone
(917) 406-3069
NPI assigned
Aug 26, 2008
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Dr. Chaitanya Kadiyala, M.D.NPI 1881662922
Title
Ceo
Phone
(917) 406-3069

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 142907 NY
Anesthesiology Physician 207L00000X 232151 NY Primary
Gastroenterology Physician 207RG0100X 232151 NY

Addresses

Primary practice location

989 W Jericho Tpke Ste 1
Smithtown, NY 11787-3241

Mailing address

565 Plandome Rd # 286
Manhasset, NY 11030-1945
Phone (174) 063-0699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121025000464 NY Part B Supplier - Clinic/Group Practice 7416107560 Receives reassigned benefits from 12 practitioners
Practice locations: Brooklyn, NY; Smithtown, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

303 5th Ave
Rm 706
New York, NY 10016
Phone (212) 679-0009

1432 Hylan Blvd
Bsmt
Staten Island, NY 10305

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1699922294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 PLANDOME RD # 286",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110301945",
            "telephone_number": "174-063-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 W JERICHO TPKE STE 1",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873241",
            "telephone_number": "917-406-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANHATTAN MEDICAL PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-26",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "KADIYALA",
        "authorized_official_first_name": "CHAITANYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-406-3069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "142907",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "232151",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "232151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.