Active NPI
Madhavi Ponnapalli, MD
- Infectious Disease Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 200832
- Practice address
- 17 E 102ND St
New York, NY 10029-5204 - Phone
- (212) 241-7968
- Fax
- (212) 824-2312
- NPI assigned
- Jan 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | MA68935 | NJ | |
| Infectious Disease Physician | 207RI0200X | 200832 | NY | Primary |
Addresses
Primary practice location
17 E 102ND St
New York, NY 10029-5204
Mailing address
150 E 42ND St FL 9
New York, NY 10017-5699
Phone (646) 605-8186
Other practice location 1
1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (212) 241-6500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 221957468 | Other | NJ | TAX ID |
| 7966407 | Medicaid | NJ |
Other names 1
- Dr. Madhavi Tallavajhala
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Infectious Disease
- Education
- Icahn School of Medicine at Mount Sinai, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
17 E 102ND St
New York, NY 10029-5204
Phone (212) 659-8551
Hospital & facility affiliations
- Mount Sinai Hospital
- Mount Sinai West
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA68935 | NJ | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Id Care LLC | Infectious Disease | Current | Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Infectious Disease | Current | Accepting new patients |
| Mount Sinai Hospital | Past | Accepting new patients |
Locations
579A Cranbury Rd
Ste 102
East Brunswick, NJ 08816
Phone (732) 613-0711
105 Raider Blvd
Ste 101
Hillsborough, NJ 08844
Phone (908) 281-0221
17 E 102nd St
New York, NY 10029
Phone (212) 241-7968
150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Organizations & group practices 5
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.
-
- Orthopaedic Surgery Physician
- New York, NY
- NPI 1124550280
-
- Infectious Disease Physician
- Hillsborough, NJ
- NPI 1639146277
-
- Infectious Disease Physician
- New York, NY
- NPI 1659639524
-
- Eyewear Supplier
- New York, NY
- NPI 1760227466
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Long Island City, NY
- NPI 1245248939
-
- Rehabilitation Hospital
- New York, NY
- NPI 1669440327
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
- General Acute Care Hospital
- New York, NY
- NPI 1225295512
-
- General Acute Care Hospital
- New York, NY
- NPI 1104982917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1821068495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 E 42ND ST FL 9",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100175699",
"telephone_number": "646-605-8186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 E 102ND ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100295204",
"telephone_number": "212-241-7968",
"fax_number": "212-824-2312"
}
],
"practiceLocations": [
{
"address_1": "1 Gustave L Levy Pl",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100296504",
"country_code": "US",
"telephone_number": "212-241-6500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PONNAPALLI",
"first_name": "MADHAVI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NJ",
"license": "MA68935",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NY",
"license": "200832",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "221957468",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7966407",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MADHAVI",
"last_name": "TALLAVAJHALA",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
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 May 27, 2021; 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.
- 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.