NPIMap

Individual provider Active NPI

Giridhar Andhavarapu, M.D.

  • Pediatrics Physician
  • Hanford, CA
National Provider Identifier
1124097043
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A102374 Issued in CA
Practice address
1524 W Lacey Blvd
Suite 104
Hanford, CA 93230-5965
Phone
(559) 583-4505
Fax
(559) 583-4545
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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 10540 NV
Pediatrics Physician 208000000X A102374 CA Primary

Addresses

Primary practice location

1524 W Lacey Blvd
Suite 104
Hanford, CA 93230-5965

Mailing address

PO Box 2087
Hanford, CA 93232-2087
Phone (559) 583-4500

Other identifiers 2

IdentifierTypeStateIssuer
1124097043MedicaidCA
100500087MedicaidNV

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

State licenses

LicenseStateTypeSpecialty
102374CAMDClinical Social Worker
A102374CAMDPediatrics Physician
10540NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reedley Community Hospital Past Accepting new patients
Hanford Community Hospital Past Accepting new patients
Valley Children'S Hospital Past Accepting new patients
Portland Adventist Medical Center Past Accepting new patients

Organizations & group practices 4

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1124097043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2087",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932322087",
            "telephone_number": "559-583-4500",
            "fax_number": "559-583-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 W LACEY BLVD",
            "address_2": "SUITE 104",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305965",
            "telephone_number": "559-583-4505",
            "fax_number": "559-583-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDHAVARAPU",
        "first_name": "GIRIDHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "10540",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A102374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124097043",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100500087",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.