PRACHI GAUTAM
NPI 1740687755
Pediatrics - Pediatric Nephrology in Bronx, NY

Q: What is Prachi Gautam's NPI number?

The NPI number for Prachi Gautam is 1740687755. It was assigned to this individual provider in the NPPES registry on November 20, 2014.

Q: What is Prachi Gautam's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

Q: When was this NPI record last updated?

The NPPES record for Prachi Gautam was last updated on June 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 November 20, 2014PECOS Enrolled

2015 GRAND CONCOURSE, BRONX, NY 10453(718) 299-7295 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 15, 2021, Jul 12, 2018 (2 updates tracked since 2018).

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About Prachi Gautam NPPES

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

PRACHI GAUTAM (NPI 1740687755) is an individual pediatric nephrology provider in Bronx, New York, licensed in New York (291597) and active in the NPI registry since November 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740687755

Entity TypeIndividualFemale

Primary Taxonomy2080P0210X

Provider Legal NamePRACHI GAUTAM

Location Address2015 GRAND CONCOURSEBronx, NY 10453

Mailing Address1434 Williamsbridge RdBronx, NY 10461-2507 · (718) 618-0401 · Fax (347) 479-1303

Phone(718) 299-7295

Sole ProprietorNo

Enumeration DateNovember 20, 2014

Last NPPES UpdateJune 15, 20212 updates tracked since enumeration

NPPES CertifiedJune 15, 2021

✔ NPI 1740687755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0210X

License✔ Licensed in NY · 291597

Definition

A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2015 GRAND CONCOURSE, Bronx, NY 10453

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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)

Prachi Gautam 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.

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.

MANA RAO M.D.

Internal Medicine (Infectious Disease)