Individual provider Active NPI

Radhika V Pasupuleti, PH.D.

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1730502329
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
021182 Issued in NY
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

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

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

Verify at the official NPI Registry.