Individual provider Active NPI

Vathani Sharon Packianathan, M.D.

  • Allergy & Immunology Physician
  • New York, NY
National Provider Identifier
1720370869
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
284414 Issued in NY
Practice address
200 West 57TH Street
15TH and 16TH Street
New York, NY 10019
Phone
(212) 247-8100
NPI assigned
May 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 284414 NY Primary

Addresses

Primary practice location

200 West 57TH Street
15TH and 16TH Street
New York, NY 10019

Mailing address

333 International Dr
B1
Williamsville, NY 14221-5726
Phone (716) 633-5277

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
I20160831002702 NY Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 4688960578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W 57TH St
New York, NY 10019-3211
Phone (212) 663-6604

55 E 34TH St
New York, NY 10016-4337
Phone (212) 252-6131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284414NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince May 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Buffalo Medical Group, P.C. Internal Medicine PastSince Aug 15, 2016 Accepting new patients

Locations

200 W 57th St
Fl 1516
New York, NY 10019
Phone (212) 247-8100

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

200 W 57th St
Ste 1410
New York, NY 10019
Phone (212) 247-8100

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

200 W 57th St
Fl 15
New York, NY 10019
Phone (212) 247-8100

150 E 42nd St
New York, NY 10017
Phone (212) 661-8139

Networks

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

Organizations & group practices 4

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": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1720370869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 INTERNATIONAL DR",
            "address_2": "B1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215726",
            "telephone_number": "716-633-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WEST 57TH STREET",
            "address_2": "15TH AND 16TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-247-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKIANATHAN",
        "first_name": "VATHANI",
        "middle_name": "SHARON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "284414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.