Active NPI
Chamkirkishtiah Panduranga Rao
- Pediatrics Physician
- Mohawk, NY
National Provider Identifier
1942307384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 150274
- Practice address
- 19 W Main St
Mohawk, NY 13407-1024 - Phone
- (315) 866-7766
- NPI assigned
- Sep 20, 2006
- Last updated
- Mar 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 150274 | NY | |
| Pediatrics Physician | 208000000X | 150274 | NY | Primary |
Addresses
Primary practice location
19 W Main St
Mohawk, NY 13407-1024
Mailing address
19 W Main St
Mohawk, NY 13407-1024
Phone (315) 866-7766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00803269 | Medicaid | NY |
Other names 1
- Dr. Chamkurkishtiah Panduranga Rao
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150274 | NY | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C.P. Rao, MD, PC | Allergy & Immunology | Past | Accepting new patients |
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, 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": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711411200000",
"number": "1942307384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 W MAIN ST",
"city": "MOHAWK",
"state": "NY",
"postal_code": "134071024",
"telephone_number": "315-866-7766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 W MAIN ST",
"city": "MOHAWK",
"state": "NY",
"postal_code": "134071024",
"telephone_number": "315-866-7766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAO",
"first_name": "CHAMKIRKISHTIAH",
"middle_name": "PANDURANGA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2024-03-26",
"certification_date": "2024-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "NY",
"license": "150274",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "150274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00803269",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHAMKURKISHTIAH",
"last_name": "RAO",
"middle_name": "PANDURANGA",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Mohawk, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.