Active NPI
Prasad Varghese Thaivalappil
- Pharmacist
- Jackson Heights, NY
National Provider Identifier
1730834375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 068840
- Practice address
- 8911 Northern Blvd
Jackson Heights, NY 11372-1674 - Phone
- (718) 426-2508
- NPI assigned
- Feb 12, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 068840 | NY | Primary |
Addresses
Primary practice location
8911 Northern Blvd
Jackson Heights, NY 11372-1674
Mailing address
52 Stuart Dr
Syosset, NY 11791-5126
Phone (732) 486-5143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068840 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Jackson Heights, NY
- NPI 1114025756
-
- Pharmacy
- Brooklyn, RI
- NPI 1679459481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644624000000",
"number": "1730834375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 STUART DR",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117915126",
"telephone_number": "732-486-5143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8911 NORTHERN BLVD",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113721674",
"telephone_number": "718-426-2508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAIVALAPPIL",
"first_name": "PRASAD",
"middle_name": "VARGHESE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-12",
"last_updated": "2022-02-12",
"certification_date": "2022-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "068840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.