Individual provider Active NPI

Sanjeeb Sudarshan Bhandari, M.D.

  • Emergency Medicine Physician
  • Cumberland, MD
National Provider Identifier
1235629239
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0093442 Issued in MD
Practice address
12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone
(667) 218-8253
Fax
(240) 964-7000
NPI assigned
May 15, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X D0093442 MD Primary

Addresses

Primary practice location

12500 Willowbrook Rd
Cumberland, MD 21502-6393

Mailing address

12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone (667) 218-8253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220614002799 MD Practitioner - Emergency Medicine 8022497502 Reassigns benefits to 1 organization
I20260616004471 WA Practitioner - Emergency Medicine 8022497502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

603 S Chestnut St
Ellensburg, WA 98926-3875

PO Box
Suite 5299
Tacoma, WA 98415

Hospital & facility affiliations

  • Western Maryland Regional Medical Center Hospital, Cumberland, MD, CCN 210027
  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0093442MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Health, LLC Single Specialty CurrentSince Jun 15, 2022 Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1235629239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 WILLOWBROOK RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026393",
            "telephone_number": "667-218-8253",
            "fax_number": "240-964-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 WILLOWBROOK RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026393",
            "telephone_number": "667-218-8253",
            "fax_number": "240-964-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHANDARI",
        "first_name": "SANJEEB",
        "middle_name": "SUDARSHAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-15",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0093442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.