NPIMap

Individual provider Active NPI

Pradeep Penta, MD

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • New York, NY
National Provider Identifier
1982801874
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
256722 Issued in NY
Practice address
317 E 34TH St FL 9
Murray Hill Medical Group
New York, NY 10016-4974
Phone
(212) 726-7400
Fax
(212) 981-7220
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 256722 NY
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 256722 NY Primary

Addresses

Primary practice location

317 E 34TH St FL 9
Murray Hill Medical Group
New York, NY 10016-4974

Mailing address

317 E 34TH St FL 9
Murray Hill Medical Group
New York, NY 10016-4974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000438 NY Practitioner - Physical Medicine and Rehabilitation 0648430215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

317 E 34TH St
New York, NY 10016-4974
Phone (212) 726-7400

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256722NYMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2019 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2019 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients
New York University PastSince Feb 6, 2012 Accepting new patients

Locations

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

317 E 34th St
New York, NY 10016
Phone (212) 263-9741

317 E 34th St
Fl 9
New York, NY 10016
Phone (212) 726-7400

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ppenta680851@nychhc.direct-ci.com

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.

Hospital & facility affiliations 7

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1982801874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E 34TH ST FL 9",
            "address_2": "MURRAY HILL MEDICAL GROUP",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 E 34TH ST FL 9",
            "address_2": "MURRAY HILL MEDICAL GROUP",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164974",
            "telephone_number": "212-726-7400",
            "fax_number": "212-981-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTA",
        "first_name": "PRADEEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "256722",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "256722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.