Vijaya Gandham, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2100491 Issued in NY

Practice address

813 Saratoga Rd
Rte 50
Burnt Hills, NY 12027-9568

Phone

(518) 384-5683

Fax

(518) 384-3361

NPI assigned

Dec 6, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

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.

• Hudson Mohawk Pediatric & Adolescent Medicine

  • Specialist
  • Ballston Lake, NY
  • NPI 1306950563
  NPD (past)
• Hudson Mohawk Pediatrics

  • Children's Hospital
  • Ballston Lake, NY
  • NPI 1225393986
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1194709899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 RUHLE RD S",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191030",
            "telephone_number": "518-899-4133",
            "fax_number": "518-899-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 SARATOGA RD",
            "address_2": "RTE 50",
            "city": "BURNT HILLS",
            "state": "NY",
            "postal_code": "120279568",
            "telephone_number": "518-384-5683",
            "fax_number": "518-384-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHAM",
        "first_name": "VIJAYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "2100491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00628079",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harold M Flax, FNP
• Richard Fountain, D.M.D.
• Donna Lea Fredericks, RN
• Alicia R Fuss
• Tashaunda Gamble, PHARMD
• Erin Heather Gartley, LMHC
• George B. Hughes MD Family Medicine PLLC
• Caleb A. George, D.D.S.
• David H Goetz, M.D.
• Amanda Elizabeth Kronen Grant, LCSW

• Pediatrics Physician in Burnt Hills, NY
• Providers in Burnt Hills, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.