PRADEEP KUMAR VAITLA MD NPI 1255645446

NPI Information

  • NPI: 1255645446
  • Provider Name: PRADEEP KUMAR VAITLA, MD
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2500 NORTH STATE STREET
    JACKSON, MS
    ZIP 39216
  • Phone: (601) 984-5065

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NPI Details

Pradeep Kumar Vaitla, MD is a nephrology internal medicine in Jackson, MS with 18 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Pradeep Kumar Vaitla, MD NPI is 1255645446. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2500 NORTH STATE STREET
JACKSON, MS
ZIP 39216-500
Phone: (601) 984-5065
Fax: (601) 984-2962

The NPI 1255645446 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Follow-up hospital inpatient care per day, typically 15 minutes (HCPCS:99231)

The enumeration date for this NPI number is 7/30/2010 and was last updated on 7/2/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyMD.206335LOUISIANANo
2207RN0300XInternal MedicineNephrology24433MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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