Active NPI
Diptish Wankhade, MD
- Family Medicine Physician
- Lebanon, PA
National Provider Identifier
1124955190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MT236619
- Practice address
- 4TH & Walnut Streets
Lebanon, PA 17046-5606 - Phone
- (717) 274-0474
- NPI assigned
- May 5, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MT236619 | PA | Primary |
Addresses
Primary practice location
4TH & Walnut Streets
Lebanon, PA 17046-5606
Mailing address
30 N 4TH St
Lebanon, PA 17046-5606
Phone (717) 274-0474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT236619 | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778716800000",
"number": "1124955190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N 4TH ST",
"city": "LEBANON",
"state": "PA",
"postal_code": "170465606",
"telephone_number": "717-274-0474",
"fax_number": "717-274-0673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4TH & WALNUT STREETS",
"city": "LEBANON",
"state": "PA",
"postal_code": "170465606",
"telephone_number": "717-274-0474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANKHADE",
"first_name": "DIPTISH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-05-05",
"last_updated": "2026-05-14",
"certification_date": "2026-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "PA",
"license": "MT236619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.