Individual provider Active NPI

Nalini U Paddu, MD

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Woodside, NY
National Provider Identifier
1982646253
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
158887 Issued in NY
Practice address
4902 Queens Blvd
Lower Level
Woodside, NY 11377-4444
Phone
(718) 784-4502
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 158887 NY Primary

Addresses

Primary practice location

4902 Queens Blvd
Lower Level
Woodside, NY 11377-4444

Mailing address

4902 Queens Boulevard
Woodside, NY 11377-4445
Phone (718) 784-4502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051110000157 NY Practitioner - Physical Medicine and Rehabilitation 0840218624 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158887NYMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Mount Sinai Hospital CurrentSince May 1, 2005 Accepting new patients
Mount Sinai Hospital CurrentSince May 1, 2005 Accepting new patients
Paddu & Associates Medical LLP CurrentSince Sep 19, 2007 Accepting new patients
Jeffrey Schneller DPM PC PastSince Aug 1, 2012 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

2715 30th Ave
Long Island City, NY 11102
Phone (718) 267-4808

4902 Queens Blvd
Woodside, NY 11377
Phone (718) 205-0550

4902 Queens Blvd
Lowr
Woodside, NY 11377
Phone (718) 729-1952

Organizations & group practices 4

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1982646253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 QUEENS BOULEVARD",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774445",
            "telephone_number": "718-784-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 QUEENS BLVD",
            "address_2": "LOWER LEVEL",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774444",
            "telephone_number": "718-784-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDU",
        "first_name": "NALINI",
        "middle_name": "U",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "158887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.