1. Home
  2. Directory
  3. New York
  4. Bronx
  5. Pediatrics
  6. NPI Profile

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

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: November 01, 2026.

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

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 and maintains a secondary practice location in Brooklyn.

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
Open in Google Maps ↗

Secondary Practice Location 1

Location 1450 Clarkson AveBrooklyn, NY 11203-2012 · Phone (718) 270-2078 · Fax (718) 683-8677

Medicare Participation & PECOS CMS

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

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.

Medicare Billing Reassignment

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

Essen Medical Associates, PC
Same address
Legal Medicine
2015 GRAND CONCOURSE
Bronx, NY 10453
  • Reassigned Medicare billing, New York enrollment
  • 1,393 clinicians in this Medicare group
NPI 1366418709 (718) 583-7736

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.

MANA RAO M.D.
Internal Medicine (Infectious Disease)
2015 GRAND CONCOURSE
BRONX, NY 10453
Bronx County (718) 299-7295
TANDIKA BOATSWAIN NP
Nurse Practitioner (Family)
2015 GRAND CONCOURSE
BRONX, NY 10453
Bronx County (718) 299-7295
DR. KESHAV TEELUCKSINGH MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
2015 GRAND CONCOURSE
BRONX, NY 10453
Bronx County (718) 299-7295
LATOYA BETTON NP
Nurse Practitioner (Family)
2015 GRAND CONCOURSE
BRONX, NY 10453
Bronx County (718) 299-7295
CYNTHIA JEAN
Nurse Practitioner (Family)
2015 GRAND CONCOURSE
BRONX, NY 10453
Bronx County (718) 299-7295
MS. RASHANA P THOMPSON NP, RN
Nurse Practitioner (Family)
2015 GRAND CONCOURSE
BRONX, NY 10453
Bronx County (718) 299-7295
PAUL CHEN DO
Family Medicine
2015 GRAND CONCOURSE
BRONX, NY 10453
Bronx County (718) 299-7295
JOY MARIE SHAKELTON WHNP-BC, CRNP
Nurse Practitioner (Women's Health)
2015 GRAND CONCOURSE
BRONX, NY 10453
Bronx County (718) 583-7736

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 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.

Where is Prachi Gautam located?

Prachi Gautam practices at 2015 Grand Concourse, Bronx, NY 10453. The listed phone number is (718) 299-7295.

What is Prachi Gautam's specialty?

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

Is Prachi Gautam enrolled in Medicare?

Yes. Prachi Gautam is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Prachi Gautam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prachi Gautam reassigns Medicare benefits to Essen Medical Associates, PC (Bronx, 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 Prachi Gautam'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 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.