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NPI Code Detail

MEDICARE: CONGENITAL HEART COMPASS MEDICAL PLLC

MEDICARE: CONGENITAL HEART COMPASS MEDICAL PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RA0002XAdult Congenital Heart Disease Physician
22080P0202XPediatric Cardiology Physician

General Provider Information

NPI Number : 1427910009
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONGENITAL HEART COMPASS MEDICAL PLLC
Provider Business Mailing Address
First Line : 62 EMPIRE BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14609-4356
Country : US
Telephone Number : 585-340-7402
Fax Number : 585-326-6129
Provider Business Practice Location Address
First Line : 62 EMPIRE BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14609-4356
Country : US
Telephone Number : 585-340-7402
Fax Number : 585-326-6129
Authorized Official
Title or Position : FOUNDER/CEO
Name : DR. PRADEEPKUMAR CHARLA
Credential : MD
Telephone Number : 585-340-7402
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “CONGENITAL HEART COMPASS MEDICAL PLLC ” Practice Location

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