NPIMap

Individual provider Active NPI

Sandeep Vardan, MD

  • Specialist
  • Bluefield, WV
National Provider Identifier
1073676110
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
19508 Issued in WV
Practice address
496 Cherry St
Building C
Bluefield, WV 24701-3304
Phone
(304) 327-1894
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 19508 WV Primary

Addresses

Primary practice location

496 Cherry St
Building C
Bluefield, WV 24701-3304

Mailing address

496 Cherry St
Building C
Bluefield, WV 24701-3304
Phone (304) 327-1894

Other identifiers 6

IdentifierTypeStateIssuer
001711019OtherWVBLUECROSS BLUESHIELD
005842981MedicaidWV
0081887000MedicaidWV
215690OtherWVTRIGON
5238590OtherWVAETNA
005842981MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bluefield Vascular Center Past Accepting new patients
Vijaykumar R Phade MD PC PastSince Nov 3, 2009 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073676110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 CHERRY ST",
            "address_2": "BUILDING C",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013304",
            "telephone_number": "304-327-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 CHERRY ST",
            "address_2": "BUILDING C",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013304",
            "telephone_number": "304-327-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDAN",
        "first_name": "SANDEEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "19508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "001711019",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005842981",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081887000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON",
            "identifier": "215690",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5238590",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005842981",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.