DR. PRATIKA MIKKILINENI MD
NPI 1053040162
Pediatrics - Adolescent Medicine in Montclair, NJ
About Dr. Pratika Mikkilineni Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. PRATIKA MIKKILINENI MD (NPI 1053040162) is an individual adolescent medicine provider in Montclair, New Jersey, licensed in New Jersey (25MA12725400) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Bronx.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Pratika Mikkilineni Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Pratika Mikkilineni reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Berkeley Heights, NJ 07922
- Reassigned Medicare billing, New Jersey enrollment
- 1,184 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Pratika Mikkilineni's NPI number?
The NPI number for Pratika Mikkilineni is 1053040162. It was assigned to this individual provider in the NPPES registry on June 6, 2022.
Where is Pratika Mikkilineni located?
Pratika Mikkilineni practices at 1 Seymour St, Montclair, NJ 07042. The listed phone number is (973) 744-6939.
What is Pratika Mikkilineni's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.
Is Pratika Mikkilineni enrolled in Medicare?
Yes. Pratika Mikkilineni is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Pratika Mikkilineni's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Pratika Mikkilineni reassigns Medicare benefits to Summit Medical Group PA (Berkeley Heights, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pratika Mikkilineni's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Pratika Mikkilineni accept?
Health plans from Ambetter Health and Oscar Health list Pratika Mikkilineni as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Pratika Mikkilineni was last updated on August 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Pratika Mikkilineni, MD · NPI 1053040162
Adolescent Medicine physician in Montclair, New Jersey. Individual provider, active in the CMS NPPES registry since June 6, 2022.
## Identity
- **NPI:** 1053040162 (Entity type: Individual)
- **Enumerated:** June 6, 2022
- **Primary specialty:** Pediatrics - Adolescent Medicine · taxonomy 2080A0000X
- **State license:** 25MA12725400 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 SEYMOUR ST, Montclair, NJ 07042-3771
- **Phone:** (973) 744-6939
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Summit Medical Group PA (NPI 1942254347, Berkeley Heights, NJ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 26, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1053040162) · Data from the CMS NPPES public registry.