DR. PRATHIMA NANDIVADA (M.D.) – Pediatric Surgery Physician, NPI 1184936320

DR. PRATHIMA NANDIVADA (M.D.) is a healthcare provider. based in Boston, Massachusetts. specializing in GENERAL SURGERY. They hold the professional credentials M.D.. They hold a License No. 253386 (MA). The NPI Number for DR. PRATHIMA NANDIVADA (M.D.) is 1184936320

Main info

Female
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. PRATHIMA NANDIVADA (M.D.)
NPI
1184936320
Phone
(617) 355-6000
Address
300 LONGWOOD AVE
Enumeration Date
3 July 2010
Last Update Date
16 June 2020

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Secondary Phone
6173556000
Graduation Year
2010 (16 years ago)
PAC ID
6204102312
Group Practice PAC ID
7012016488
Professional Enrollment ID
I20200710002195
Address ID
MA021155724BO300XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

1,028 GENERAL SURGERY in MA

Provider Addresses for DR. PRATHIMA NANDIVADA (M.D.)

  • 300 LONGWOOD AVE

    BOSTON, MA 021155724

    Phone: (617) 355-6000

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-07-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200710002195IGeneral SurgeryMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02115)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012016488View full group profile
NameSpecialtyState
General SurgeryMA
General Surgery, Pediatric MedicineMA
-MA
-MA
General SurgeryMD
General SurgeryMA
General Surgery, Pediatric MedicineMA
General Surgery, Critical Care (Intensivists)MA
Nurse PractitionerMA
General SurgeryMA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. PRATHIMA NANDIVADA (M.D.)'s NPI?
Yes. DR. PRATHIMA NANDIVADA (M.D.) is listed with NPI 1184936320 in the public NPI dataset.
Does CMS list DR. PRATHIMA NANDIVADA (M.D.) as active?
Yes — DR. PRATHIMA NANDIVADA (M.D.) is active in the NPI listing used on this page.
What healthcare role does DR. PRATHIMA NANDIVADA (M.D.) hold?
Scheduling teams often label DR. PRATHIMA NANDIVADA (M.D.) under Pediatric Surgery Physician. Clinical services aligned with this taxonomy classification.
What area does DR. PRATHIMA NANDIVADA (M.D.) serve?
DR. PRATHIMA NANDIVADA (M.D.)'s listing highlights Boston, Massachusetts; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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