Individual provider Active NPI

Nitya Ananthakrishnan, M.D.

  • Pediatrics Physician
  • Milford, MA
National Provider Identifier
1902190648
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
257926 Issued in MA
Practice address
14 Prospect St
Milford, MA 01757-3003
Phone
(508) 473-1190
NPI assigned
May 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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 BP10039696 TX
Pediatrics Physician 208000000X 257926 MA Primary

Addresses

Primary practice location

14 Prospect St
Milford, MA 01757-3003

Mailing address

4 Fort Washington PL
Cambridge, MA 02139-4843
Phone (201) 926-6490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20140821001572 MA Practitioner - Pediatric Medicine 5890913511 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10039696TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pediatric Associates, Inc Pediatrics CurrentSince Aug 1, 2014 Accepting new patients
Umass Memorial Health-Milford Regional Medical Center Inc Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

Organizations & group practices 2

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": "1306627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1902190648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FORT WASHINGTON PL",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394843",
            "telephone_number": "201-926-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PROSPECT ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573003",
            "telephone_number": "508-473-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANTHAKRISHNAN",
        "first_name": "NITYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-29",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10039696",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "257926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

Verify at the official NPI Registry.