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General NPI Number Information
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NPI Number | 1427910009
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Entity Type | Organization
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Legal Business Name | CONGENITAL HEART COMPASS MEDICAL PLLC
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 62 EMPIRE BLVD
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City | ROCHESTER
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State | NY
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Zip | 14609-4356
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Country | US
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Telephone | 585-340-7402
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Fax | 585-326-6129
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Provider Business Mailing Address
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Address Line | 62 EMPIRE BLVD
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City | ROCHESTER
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State | NY
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Zip | 14609-4356
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Country | US
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Telephone | 585-340-7402
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Fax | 585-326-6129
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | DR. PRADEEPKUMAR CHARLA
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Credential | MD
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Telephone | 585-340-7402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0002X
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Taxonomy Name | Adult Congenital Heart Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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