Andro T. Zangaladze, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD418139 Issued in PA

Practice address

200 Bowman Dr
Suite E385
Voorhees, NJ 08043-9623

Phone

(856) 247-7770

Fax

(856) 247-7766

NPI assigned

Jul 15, 2006

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Neurology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kennedy Medical Group Practice, P.C.

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796

  Neurology

  Medicare reassignment Care Compare group NPD
• Kennedy Medical Group Practice PC

  • Family Medicine Physician
  • Sewell, NJ
  • NPI 1952848905
  NPD
• Kennedy Medical Group Practice, P.C.

  • Surgical Oncology Physician
  • Sewell, NJ
  • NPI 1043580806
  NPD
• Chicago Medical Specialists Chartered

  • Physiological Laboratory
  • Lombard, IL
  • NPI 1639479421
  NPD
• Kennedy Medical Group Practice P.C.

  • Family Medicine Physician
  • West Deptford, NJ
  • NPI 1952615981
  NPD (past)
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  NPD (past)
• Jefferson University Physicians

  • Neurology Physician
  • Philadelphia, PA
  • NPI 1932373164
  NPD (past)

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

• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  Care Compare affiliation
• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1255358602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 FRIES MILL RD STE 301",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122016",
            "telephone_number": "856-352-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOWMAN DR",
            "address_2": "SUITE E385",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439623",
            "telephone_number": "856-247-7770",
            "fax_number": "856-247-7766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Fries Mill Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Turnersville",
            "state": "NJ",
            "postal_code": "080122016",
            "country_code": "US",
            "telephone_number": "856-352-6660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZANGALADZE",
        "first_name": "ANDRO",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD418139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001958087",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005380",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Youth Consultation Service, Inc
• Jonathan Yuh, D.O.
• Yves Manigat MD PA
• David Zalut, M.D.
• Nicole Max Zamkoff, D.O.
• Craig L. Zaretsky, M.D.
• Hossein Zarezadeh, DDS
• Alexandr Zaslavsky, MD
• Amy Z Zehnder, MD
• Klarida Zeqollari

• Neurology Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.