Active NPI
Radhika V Pasupuleti, PH.D.
- Psychologist
- Philadelphia, PA
National Provider Identifier
1730502329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 021182
- Practice address
- 3900 Woodland Ave
Philadelphia, PA 19104-4551 - Phone
- (215) 823-5800
- NPI assigned
- Feb 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Health Psychologist | 103TH0004X | |||
| Psychologist | 103T00000X | 021182 | NY | Primary |
Addresses
Primary practice location
3900 Woodland Ave
Philadelphia, PA 19104-4551
Mailing address
385 Tremont Ave
VA New Jersey Healthcare System, 11TH Floor, Wriisc
East Orange, NJ 07018-1023
Phone (973) 676-1000
Other practice location 1
385 Tremont Ave
VA New Jersey Healthcare System, 11th floor, WRIISC
East Orange, NJ 07018-1023
Phone (973) 676-1000 ext. 1606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522022400000",
"number": "1730502329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 TREMONT AVE",
"address_2": "VA NEW JERSEY HEALTHCARE SYSTEM, 11TH FLOOR, WRIISC",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070181023",
"telephone_number": "973-676-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 WOODLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044551",
"telephone_number": "215-823-5800"
}
],
"practiceLocations": [
{
"address_1": "385 Tremont Ave",
"address_2": "VA New Jersey Healthcare System, 11th floor, WRIISC",
"address_purpose": "LOCATION",
"city": "East Orange",
"state": "NJ",
"postal_code": "070181023",
"country_code": "US",
"telephone_number": "973-676-1000 x1606",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PASUPULETI",
"first_name": "RADHIKA",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-03",
"last_updated": "2018-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "021182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.