Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PRATYUSHA MUDDALOOR MD
NPI 1043903941
Internal Medicine in Syracuse, NY

Q: What is Pratyusha Muddaloor's NPI number?

The NPI number for Pratyusha Muddaloor is 1043903941. It was assigned to this individual provider in the NPPES registry on May 29, 2023.

Q: What is Pratyusha Muddaloor's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since May 29, 2023PECOS Enrolled

750 E. ADAMS ST, SYRACUSE, NY 13210(315) 464-5774(315) 464-5378 Get Directions Write a Review

NPPES record last updated: September 11, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 11, 2026, Jul 29, 2026, May 29, 2023 (3 updates tracked since 2023).

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About Pratyusha Muddaloor Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRATYUSHA MUDDALOOR MD (NPI 1043903941) is an individual internal medicine provider in Syracuse, New York, licensed in New York (345712) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1043903941

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NamePRATYUSHA MUDDALOORCredential: MD

Location Address750 E. ADAMS STSyracuse, NY 13210

Mailing Address750 E. Adams St.Syracuse, NY 13210 · (315) 464-5774 · Fax (315) 464-5378

Phone(315) 464-5774

Fax(315) 464-5378

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMay 29, 2023

Last NPPES UpdateSeptember 11, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2026

✔ NPI 1043903941 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NY · 345712

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

750 E. ADAMS ST, Syracuse, NY 13210

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pratyusha Muddaloor Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719330927

PECOS Enrollment IDI20260728002407

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VENKATA SATISH KUMAR SAMPATHI MBBS

Anesthesiology

750 E. ADAMS ST, UPSTATE MEDICAL UNIVERSITY
SYRACUSE, NY 13210

Onondaga County (315) 469-1130

DR. FAWAZ ARAIM MD

Surgery (Vascular Surgery)