DR. MRUDULA PREMKUMAR M.D
NPI 1225583180
Pediatrics in Nyack, NY

Q: What is Mrudula Premkumar's NPI number?

The NPI number for Mrudula Premkumar is 1225583180. It was assigned to this individual provider in the NPPES registry on August 22, 2016. The provider is also known as Dr. Mrudula Maddali M.D.

Q: What is Mrudula Premkumar's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Mrudula Premkumar was last updated on February 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since August 22, 2016PECOS Enrolled

160 N MIDLAND AVE, NYACK, NY 10960(973) 615-6662 Get Directions Write a Review

NPPES record last updated: February 14, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 14, 2020, Jul 8, 2019, Aug 22, 2016 (3 updates tracked since 2016).

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About Dr. Mrudula Premkumar M.d NPPES

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

DR. MRUDULA PREMKUMAR M.D (NPI 1225583180) is an individual pediatrics provider in Nyack, New York, licensed in New York (299538) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225583180

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. MRUDULA PREMKUMARCredential: M.D

Location Address160 N MIDLAND AVENyack, NY 10960-1912

Mailing Address61 Davis Ave Apt QWhite Plains, NY 10605-1009 · (973) 615-6662

Phone(973) 615-6662

Sole ProprietorNo

Enumeration DateAugust 22, 2016

Last NPPES UpdateFebruary 14, 20203 updates tracked since enumeration

✔ NPI 1225583180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in NY · 299538

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

160 N MIDLAND AVE, Nyack, NY 10960

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Other Names 1

Former Name (1)Dr. Mrudula Maddali M.d

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mrudula Premkumar M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mrudula Premkumar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Inpatient Medical Associates Of New York PLLC

Same address

Pediatric Emergency Medicine

160 N MIDLAND AVE
Nyack, NY 10960

Reassigned Medicare billing, New York enrollment
11 clinicians in this Medicare group

NPI 1063717791 (954) 939-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10960 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

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

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 20

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

KRISTINE M. RIVERA CRNA

Nurse Anesthetist, Certified Registered

160 N MIDLAND AVE, NYACK HOSPITAL
NYACK, NY 10960

Rockland County (845) 348-2862

PREM S. MEHTA MD

Anesthesiology

160 N MIDLAND AVE, NYACK HOSPITAL
NYACK, NY 10960

Rockland County (845) 348-2862

PAMELA CHARNEY MD

Internal Medicine

160 N MIDLAND AVE, ADULT HOSPITAL MEDICINE, NYACK HOSPITAL
NYACK, NY 10960

Rockland County (845) 348-2000

ZENA JUSTICE CRNA

Nurse Anesthetist, Certified Registered

160 N MIDLAND AVE, NYACK HOSPITAL
NYACK, NY 10960

Rockland County (845) 348-2862

DR. BORIS MELNIKAU M.D.

Internal Medicine

160 N MIDLAND AVE
NYACK, NY 10960

Rockland County (845) 348-8884

MONA PEREZ N.P.

Nurse Practitioner

160 N MIDLAND AVE, NYACK HOSPITAL
NYACK, NY 10960

Rockland County (845) 348-2345

DR. JAE HO LEE MD

Anesthesiology

160 N MIDLAND AVE, NYACK HOSPITAL
NYACK, NY 10960

Rockland County (914) 666-8866

MR. JAYESH SAMPAT M.D.

Internal Medicine

160 N MIDLAND AVE
NYACK, NY 10960

Rockland County (845) 348-2000

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 Mrudula Premkumar's NPI number?

The NPI number for Mrudula Premkumar is 1225583180. It was assigned to this individual provider in the NPPES registry on August 22, 2016. The provider is also known as Dr. Mrudula Maddali M.D.

Where is Mrudula Premkumar located?

Mrudula Premkumar practices at 160 N Midland Ave, Nyack, NY 10960. The listed phone number is (973) 615-6662.

What is Mrudula Premkumar's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mrudula Premkumar enrolled in Medicare?

Yes. Mrudula Premkumar is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mrudula Premkumar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mrudula Premkumar reassigns Medicare benefits to Inpatient Medical Associates Of New York PLLC (Nyack, 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 Mrudula Premkumar'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 Mrudula Premkumar was last updated on February 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.