Individual provider Active NPI

Kunal Anandpara, DO

  • Sports Medicine (Family Medicine) Physician
  • Philadelphia, PA
National Provider Identifier
1003438649
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
OS024153 Issued in PA
Practice address
11000 Roosevelt Blvd
Philadelphia, PA 19116-3961
Phone
(215) 677-1475
Fax
(215) 677-3082
NPI assigned
May 16, 2020
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X OS024153 PA Primary

Addresses

Primary practice location

11000 Roosevelt Blvd
Philadelphia, PA 19116-3961

Mailing address

3500 N Broad St RM 1a
Philadelphia, PA 19140-4106
Phone (215) 677-1475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241017003512 PA Practitioner - Family Practice 7416489216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rowan University School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Physicians IncGroup PAC ID 2062317233, 154 clinicians

Practice addresses (Care Compare)

11000 Roosevelt Blvd
Suite 360
Philadelphia, PA 19116-3961
Phone (215) 677-1475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince Oct 1, 2024 Accepting new patients
Temple Physicians Inc. CurrentSince Oct 1, 2024 Accepting new patients
Temple Physicians Inc Current Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

11000 Roosevelt Blvd
Philadelphia, PA 19116
Phone (215) 214-6655

11000 Roosevelt Blvd
#360
Philadelphia, PA 19116
Phone (215) 677-1475

2118 Cottman Ave
Philadelphia, PA 19149
Phone (215) 342-3020

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1003438649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST RM 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-677-1475",
            "fax_number": "215-677-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163961",
            "telephone_number": "215-677-1475",
            "fax_number": "215-677-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANDPARA",
        "first_name": "KUNAL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-16",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "OS024153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.