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, billing reassignment, and ordering and referring status from CMS.
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).
Medicare Billing Reassignment
Medicare enrollment records show Noah Kondamudi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Brooklyn, NY 11201
- Reassigned Medicare billing, New York enrollment
- 27 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 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.
Which organization bills Medicare for Noah Kondamudi's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Noah Kondamudi reassigns Medicare benefits to Tbhc Pediatric Services PC (Brooklyn, NY). 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 Noah Kondamudi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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
- **Bills Medicare through:** Tbhc Pediatric Services PC (NPI 1861628091, Brooklyn, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## 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.