NANDANEE MYNENI (PA-C) – Physician Assistant, NPI 1487872131

NANDANEE MYNENI (PA-C) is a healthcare provider. based in Jersey city, New Jersey. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 25MP00178400 (NJ). The NPI Number for NANDANEE MYNENI (PA-C) is 1487872131

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
NANDANEE MYNENI (PA-C)
NPI
1487872131
Phone
(201) 216-3040
Address
1 JSQ PLAZA
Enumeration Date
20 April 2007
Last Update Date
19 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9083529556
Graduation Year
2006 (20 years ago)
PAC ID
7719042621
Group Practice PAC ID
9133174626
Professional Enrollment ID
I20090210000135
Address ID
NJ072014708EL824XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,578 PHYSICIAN ASSISTANT in NJ

Provider Addresses for NANDANEE MYNENI (PA-C)

  • 1 JSQ PLAZA

    JERSEY CITY, NJ 07306

    Phone: (201) 216-3040

    Type: Location

  • 600 PAVONIA AVE

    JERSEY CITY, NJ 073062929

    Phone:

    Type: Mailing

  • 824 ELIZABETH AVE

    ELIZABETH, NJ 072014708

    Phone: (908) 352-9556

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 173 Open Payments records for all available years, with a total value of $3,149.

Total Amount is formed as General ($3,149) + Research ($0) + Ownership ($0) = $3,149.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Amgen Inc. ($504).

Total Amount

$3,149

General + Research + Ownership

Payments

173

Total payment records

General Amount

$3,149

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2009-02-10

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
I20090210000135IPhysician AssistantNJTBD

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 07306)

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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: 9133174626View full group profile
NameSpecialtyState
Internal MedicineNJ
Internal MedicineNJ
Internal MedicineNJ

Reviews

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Frequently asked questions

How do payers reference NANDANEE MYNENI (PA-C)?
For NANDANEE MYNENI (PA-C), use NPI 1487872131 as the unique 10-digit identifier.
Is there an active status for NANDANEE MYNENI (PA-C)?
For scheduling context, NANDANEE MYNENI (PA-C) is shown as active in the registry.
What area of care is associated with NANDANEE MYNENI (PA-C)?
NANDANEE MYNENI (PA-C)'s record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
Is NANDANEE MYNENI (PA-C) associated with Jersey City?
Public fields place NANDANEE MYNENI (PA-C) around Jersey City, New Jersey. Always confirm the exact site before visiting.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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