Individual provider Active NPI

Nandita Patnaik, M.D.

  • Pediatrics Physician
  • King of Prussia, PA
National Provider Identifier
1881956092
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD456064 Issued in PA
Practice address
550 S Goddard Blvd
King of Prussia, PA 19406-2922
Phone
(610) 337-3232
NPI assigned
Jun 13, 2012
Last updated
Jun 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD456064 PA Primary

Addresses

Primary practice location

550 S Goddard Blvd
King of Prussia, PA 19406-2922

Mailing address

550 S Goddard Blvd
King of Prussia, PA 19406-2922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180102000629 PA Practitioner - Pediatric Medicine 5597023283 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Nov 1, 2017 Accepting new patients
Greater Philadelphia Health Action Inc. Current Accepting new patients
Greater Philadelphia Health Action, Inc. CurrentSince Oct 29, 2018 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Nov 1, 2017 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Greater Philadelphia Health Action Inc. CurrentSince Oct 29, 2018 Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

432 N 6th St
Philadelphia, PA 19123
Phone (215) 627-8000

5501 Woodland Ave
Philadelphia, PA 19143
Phone (215) 724-4700

800 Washington Ave
Philadelphia, PA 19147
Phone (215) 339-5100

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1881956092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S GODDARD BLVD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S GODDARD BLVD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062922",
            "telephone_number": "610-337-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATNAIK",
        "first_name": "NANDITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD456064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

Verify at the official NPI Registry.