Individual provider Active NPI

Vidyasagar Anmangandla, M.D.

  • Internal Medicine Physician
  • White Plains, MD
National Provider Identifier
1073589206
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0026064 Issued in MD
Practice address
10583 Theodore Green Blvd
White Plains, MD 20695-3022
Phone
(301) 934-9300
Fax
(301) 934-6963
NPI assigned
Feb 27, 2006
Last updated
Mar 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0026064 MD Primary

Addresses

Primary practice location

10583 Theodore Green Blvd
White Plains, MD 20695-3022

Mailing address

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-7900

Other identifiers 1

IdentifierTypeStateIssuer
769601900MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051006000408 MD Practitioner - Internal Medicine 8921023292 Reassigns benefits to 1 organization
Practice locations: White Plains, MD
I20260327000261 DC Practitioner - Internal Medicine 8921023292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10583 Theodore Green Blvd
White Plains, MD 20695-3022
Phone (301) 934-9300

24035 Three Notch Rd
Hollywood, MD 20636-4871

PO Box
Suite 640
Hollywood, MD 20636

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as individual
Quality
89.79
Promoting interoperability
62
Improvement activities
40
Cost
86.8

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group - Southern Maryland LLC Internal Medicine Past Accepting new patients
Medstar Medical Group - Southern Maryland LLC Internal Medicine PastSince Sep 1, 2026 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1073589206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10583 THEODORE GREEN BLVD",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953022",
            "telephone_number": "301-934-9300",
            "fax_number": "301-934-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANMANGANDLA",
        "first_name": "VIDYASAGAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0026064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "769601900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, MD

Sources for this page

Verify at the official NPI Registry.