Praveen Kadimcherla, M.D.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

25MA09481800 Issued in NJ

Practice address

475 Prospect Ave
Suite 110
West Orange, NJ 07052-4197

Phone

(973) 419-0200

NPI assigned

Feb 6, 2011

Last updated

Jun 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthopaedic Clinical Assoc Inc.

  • Specialist
  • Roxbury Crossing, MA
  • NPI 1578528949
  NPD (past)

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

{
    "created_epoch": "1296950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1700182946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE",
            "address_2": "SUITE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524197",
            "telephone_number": "973-419-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE",
            "address_2": "SUITE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524197",
            "telephone_number": "973-419-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADIMCHERLA",
        "first_name": "PRAVEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-06",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NJ",
            "license": "25MA09481800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Otolaryngology .P.C.
• Mistral G Joseph, APN
• Myrcie Joseph
• Jouvanz Health and Wellness LLP
• Patricia M Judd, PT
• Devin Kadis, DPT
• Iftekhar Kadri, M.D.
• Neil Kahanovitz, M.D.
• Kaj Personal Care Services LLC
• Leah B Kaltman, MD

• Orthopaedic Surgery of the Spine Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Orthopaedic Surgery of the Spine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.