NOAH PRAVEEN KUMAR KONDAMUDI M.D.
NPI 1114958451
Pediatrics - Pediatric Emergency Medicine in Newark, NJ
About Noah Praveen Kumar Kondamudi M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NOAH PRAVEEN KUMAR KONDAMUDI M.D. (NPI 1114958451) is an individual pediatric emergency medicine provider in Newark, New Jersey, licensed in New Jersey (25MA06802600) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Noah Praveen Kumar Kondamudi M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEWARK, NJ 07107
NEWARK, NJ 07107
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 Noah Kondamudi's NPI number?
The NPI number for Noah Kondamudi is 1114958451. It was assigned to this individual provider in the NPPES registry on July 5, 2006.
Where is Noah Kondamudi located?
Noah Kondamudi practices at 30 Bergen St Admc 12 1205, Newark, NJ 07107. The listed phone number is (973) 972-0037.
What is Noah Kondamudi's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.
Is Noah Kondamudi enrolled in Medicare?
Yes. Noah Kondamudi is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Noah Kondamudi was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.
# Noah Praveen Kumar Kondamudi, M.D. · NPI 1114958451
Pediatric Emergency Medicine physician in Newark, New Jersey. Individual provider, active in the CMS NPPES registry since July 5, 2006.
## Identity
- **NPI:** 1114958451 (Entity type: Individual)
- **Enumerated:** July 5, 2006
- **Primary specialty:** Pediatrics - Pediatric Emergency Medicine · taxonomy 2080P0204X
- **State license:** 25MA06802600 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 30 BERGEN ST, ADMC 12 1205, Newark, NJ 07107-3000
- **Phone:** (973) 972-0037
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicaid 8778205 (NJ); Medicare UPIN G43523; Medicare ID-Type Unspecified 059507 (NJ)
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Source: [NPI Profile](https://npiprofile.com/npi/1114958451) · Data from the CMS NPPES public registry.