Chandan Mazumder, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

P3771 Issued in TX

Practice address

1900 W Wall St Ste C
Midland, TX 79701-6568

Phone

(432) 221-2500

Fax

(432) 687-1914

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chandan.mazumder@midchs.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/EJEICD

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.

• Midland Community Healthcare Services

  • Federally Qualified Health Center (FQHC)
  • Midland, TX
  • NPI 1235225087
  Medicare reassignment NPD
• Midland Community Healthcare Services

  • Family Medicine Physician
  • Midland, TX
  • NPI 1396142931
  NPD
• Midland Community Healthcare Services

  • Federally Qualified Health Center (FQHC)
  • Midland, TX
  • NPI 1013016906
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1093928913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 ANDREWS HWY STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034817",
            "telephone_number": "432-686-6605",
            "fax_number": "432-682-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W WALL ST STE C",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797016568",
            "telephone_number": "432-221-2500",
            "fax_number": "432-687-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUMDER",
        "first_name": "CHANDAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 98432",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P3771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279640600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305512101",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chandan.mazumder.1@3522.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1900 W Wall St Ste C",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797016568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mashanda Eleah May, FNP
• Sheri L Mayo, PA-C
• Bart R Mayron, MD
• Hannah Janae Earley Mays, PA-S
• Mayta Health Systems LLC
• Festus Nji Mbakwa, PHARM D
• Uchenna Matilda Mbama
• McAndrew'S Eye Clinic
• Lindsey McAnear
• Kristina D McAuliffe, M.D.

• Pediatrics Physician in Midland, TX
• Providers in Midland, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.