Individual provider Active NPI

Prajith Mepparambath, M.D

  • Pediatric Endocrinology Physician
  • Hawthorne, NY
National Provider Identifier
1710233952
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
276111 Issued in NY
Practice address
19 Bradhurst Ave Ste 2900S
Hawthorne, NY 10532-2194
Phone
(914) 614-4343
NPI assigned
Jul 25, 2012
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 276111 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave Ste 2900S
Hawthorne, NY 10532-2194

Mailing address

400 Columbus Ave Ste 200E
Valhalla, NY 10595-1392
Phone (914) 614-4343

Other practice location 1

1900 W Polk St
Chicago, IL 60612-3723
Phone (516) 660-3925

Other practice location 2

1900 W Polk St
Chicago, IL 60612-3723
Phone (516) 660-3925

Other identifiers 1

IdentifierTypeStateIssuer
276111OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151123000951 NY Practitioner - EndocrinologyPractitioner - Pediatric Medicine 7315247467 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276111NYMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Jul 1, 2019 Accepting new patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Sep 23, 2015 Accepting new patients
Middletown Medical PC Pediatrics CurrentSince Jul 1, 2019 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

111 Maltese Dr
Middletown, NY 10940

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: prajith.mepparambath@mmpc.eclinicaldirectplus.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1710233952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE STE 200E",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951392",
            "telephone_number": "914-614-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 2900S",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322194",
            "telephone_number": "914-614-4343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 W Polk St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123723",
            "country_code": "US",
            "telephone_number": "516-660-3925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 W Polk St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123723",
            "country_code": "US",
            "telephone_number": "516-660-3925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEPPARAMBATH",
        "first_name": "PRAJITH",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-25",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "276111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "276111",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.