Individual provider Active NPI

Tahler Diane Bandarra

  • General Practice Physician
  • Bethesda, MD
National Provider Identifier
1043895501
Registry record updated Jun 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101282242 Issued in VA
Practice address
4494 North Palmer Road
Bethesda, MD 20889-0001
Phone
(301) 295-4440
NPI assigned
Mar 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101282242 VA Primary

Addresses

Primary practice location

4494 North Palmer Road
Bethesda, MD 20889-0001

Mailing address

4494 North Palmer Road
Bethesda, MD 20889-0001
Phone (301) 295-4440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20210712004193 MD Order and Referring Only - General SurgeryPractitioner - General Surgery 6800298993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781308800000",
    "number": "1043895501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4494 NORTH PALMER ROAD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-295-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 NORTH PALMER ROAD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-295-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDARRA",
        "first_name": "TAHLER",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2026-06-13",
        "certification_date": "2026-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101282242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.