Kamal Addagatla, MD is a medicare enrolled "Plastic Surgery" physician in Clifton, New Jersey. His current practice location is
1255 Broad St, Clifton, New Jersey. You can reach out to his office (for appointments etc.) via phone at
(973) 327-9584.
Kamal Addagatla is licensed to practice in New Jersey (license number 25MA10287200) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1730522061.
Physician's Profile
| Full Name | Kamal Addagatla |
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| Gender | Male |
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| Speciality | Plastic Surgery |
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| Location | 1255 Broad St, Clifton, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1730522061
- Provider Enumeration Date: 04/17/2013
- Last Update Date: 08/25/2022
Medicare PECOS Information:
- PECOS PAC ID: 7113354838
- Enrollment ID: I20210712000114
Medical Identifiers
Medical identifiers for Kamal Addagatla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1730522061 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2086S0122X | Surgery - Plastic And Reconstructive Surgery | 68908 (Connecticut) | Secondary |
| 208200000X | Plastic Surgery | 25MA10287200 (New Jersey) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kamal Addagatla allows following entities to bill medicare on his behalf.
| Entity Name | Yale University |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205822236
PECOS PAC ID: 9436061736
Enrollment ID: O20031105000015 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kamal Addagatla is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kamal Addagatla, MD
1 Diamond Hill Rd,
Berkeley Heights, NJ 07922-2104
Ph: (908) 273-4300 | Kamal Addagatla, MD
1255 Broad St,
Clifton, NJ 07013-3398
Ph: (973) 327-9584 |
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