Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Prem Thanaratnam, MD

Individual provider Vascular & Interventional Radiology Physician · NPI 1285029645

Prem Thanaratnam, MD is a Diagnostic Radiology in Bronx, New York. Qualified in 2013, 13 years ago. Practices with J Paul Wiesner and Associates Chartered, a 24-clinician group and accepts Medicare assignment. Licensed in Nevada.

Years since qualifying
13
Licensed in
NV
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (718) 696-2583
Fax: (718) 881-5074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular & Interventional Radiology Physician (primary) Taxonomy 2085R0204X · Licence 22108 (NV)

Record details

NPI number1285029645
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 2, 2015
Last updated in NPPESOctober 4, 2023
Certification dateOctober 4, 2023
Mailing address111 E 210th St, Bronx, NY 10467-2401

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice J Paul Wiesner And Associates Chartered — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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