Individual provider Active NPI

Preethi Ganesh Venkat, MD, MPH

  • Student in an Organized Health Care Education/Training Program
  • Charlottesville, VA
National Provider Identifier
1760018709
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0116037508 Issued in VA
Practice address
1215 Lee St Box #800708
Charlottesville, VA 22908-0816
Phone
(434) 924-2959
Fax
(434) 244-9495
NPI assigned
Mar 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 0116037508 VA Primary

Addresses

Primary practice location

1215 Lee St Box #800708
Charlottesville, VA 22908-0816

Mailing address

1215 Lee St Box #800708
Charlottesville, VA 22908-0816
Phone (434) 924-2959

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (619) 543-2429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20230713002994 VA Order and Referring Only - GastroenterologyPractitioner - Gastroenterology 9830559400

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: pvenkat573748@direct.healthsystem.virginia.edu

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1760018709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX #800708",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-2959",
            "fax_number": "434-244-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX #800708",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-2959",
            "fax_number": "434-244-9495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "619-543-2429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENKAT",
        "first_name": "PREETHI",
        "middle_name": "GANESH",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116037508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.