Organization Active NPI

Tahiti Pharmacy LLC

  • Community/Retail Pharmacy
  • New York, NY
National Provider Identifier
1780527572
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TAHITI PHARMACY LLC
Practice address
1486 5TH Ave
New York, NY 10035-2703
Phone
(212) 510-8133
Fax
(212) 510-8245
NPI assigned
Apr 14, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Authorized official

Name
Venkata Siva Prasad Kodali, R.PHNPI 1700133766
Title
Sole Member
Phone
(212) 510-8133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1486 5TH Ave
New York, NY 10035-2703

Mailing address

1486 5TH Ave
New York, NY 10035-2703
Phone (212) 510-8133

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Tahiti Pharmacy LLC1486 5TH Avenue, New York, NY 10035-2703(212) 510-7694 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jul 9, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1780527572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1486 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352703",
            "telephone_number": "212-510-8133",
            "fax_number": "212-510-8245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352703",
            "telephone_number": "212-510-8133",
            "fax_number": "212-510-8245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHITI PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "KODALI",
        "authorized_official_first_name": "VENKATA",
        "authorized_official_middle_name": "SIVA PRASAD",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "212-510-8133",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.