Individual provider Active NPI

Monica Milind Pradhan, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1902048341
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P2155 Issued in TX
Practice address
1108 S Henderson St
Fort Worth, TX 76104-4430
Phone
(817) 335-3255
Fax
(817) 338-9563
NPI assigned
Mar 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X P2155 TX
Pediatrics Physician 208000000X P2155 TX Primary

Addresses

Primary practice location

1108 S Henderson St
Fort Worth, TX 76104-4430

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpradhan14651@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150626000277 TX Practitioner - Pediatric Medicine 8426369810 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Aug 1, 2015 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Aug 1, 2015 Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

1108 S Henderson St
Ft Worth, TX 76104
Phone (817) 335-3255

Interoperability endpoints

  • Direct secure messaging: mpradhan14651@cookchildrens.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1902048341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044430",
            "telephone_number": "817-335-3255",
            "fax_number": "817-338-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADHAN",
        "first_name": "MONICA",
        "middle_name": "MILIND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "P2155",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P2155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpradhan14651@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1108 S Henderson St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.