Individual provider Active NPI

Malti P Damani, MD

  • Pediatrics Physician
  • Yardley, PA
National Provider Identifier
1063447266
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD035007L Issued in PA
Practice address
301 Oxford Valley Rd
#202A
Yardley, PA 19067
Phone
(215) 493-9877
Fax
(215) 493-3519
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD035007L PA Primary
Pediatrics Physician 208000000X 25MA03645300 NJ

Addresses

Primary practice location

301 Oxford Valley Rd
#202A
Yardley, PA 19067

Mailing address

301 Oxford Valley Rd
#202A
Yardley, PA 19067
Phone (215) 493-9877

Other identifiers 1

IdentifierTypeStateIssuer
1116029MedicaidPA

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
I20110510000062 PA Practitioner - Pediatric Medicine 2961688924 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03645300NJMDPediatrics Physician
MD035007LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Mar 12, 2011 Accepting new patients
City of Philadelphia CurrentSince Mar 12, 2011 Accepting new patients
City of Philadelphia Current Accepting new patients

Locations

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

1101 Market St
Fl 10
Philadelphia, PA 19107

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063447266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "#202A",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-493-9877",
            "fax_number": "215-493-3519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "#202A",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-493-9877",
            "fax_number": "215-493-3519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMANI",
        "first_name": "MALTI",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD035007L",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA03645300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116029",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yardley, PA

Sources for this page

Verify at the official NPI Registry.