Individual provider Active NPI

Gitana Bradauskaite, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1902951304
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD442152 Issued in PA
Practice address
5501 Old York Rd
Levy GRD. Floor
Philadelphia, PA 19141-3091
Phone
(215) 456-6970
Fax
(215) 456-7154
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P17477 MD
Internal Medicine Physician 207R00000X MD442152 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Levy GRD. Floor
Philadelphia, PA 19141-3091

Mailing address

PO Box 8500-8735
Philadelphia, PA 19178-0001
Phone (215) 456-7000

Other identifiers 1

IdentifierTypeStateIssuer
MD442152OtherPAMD

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
I20110908001677 PA Practitioner - Nephrology 9335292028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd Levy Ground FL
Philadelphia, PA 19141-3092
Phone (215) 456-6970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P17477MDMDInternal Medicine Physician
MD442152PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Current Accepting new patients

Locations

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

Interoperability endpoints

  • Direct secure messaging: gitana.bradauskaite@direct.einstein.edu

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1902951304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-8735",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780001",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "LEVY GRD. FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413091",
            "telephone_number": "215-456-6970",
            "fax_number": "215-456-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADAUSKAITE",
        "first_name": "GITANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "P17477",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD442152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "MD442152",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.