Individual provider Active NPI

Mathangi Anusha Chandramouli, MD

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1275055238
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD483425 Issued in PA
Practice address
1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone
(718) 240-5000
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD483425 PA Primary

Addresses

Primary practice location

1 Brookdale PLZ
Brooklyn, NY 11212-3139

Mailing address

193 Marcus Garvey Blvd Apt 304
Brooklyn, NY 11221-6287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20250220002022 PA Practitioner - General Surgery 0042730020 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Surgery CurrentSince Feb 14, 2025 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Feb 14, 2025 Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients

Locations

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

104 Hillcrest Dr
Roaring Spring, PA 16673
Phone (814) 224-5455

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: mchandramouli52918@direct.conemaugh.org

Organizations & group practices 3

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1275055238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 MARCUS GARVEY BLVD APT 304",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112216287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRAMOULI",
        "first_name": "MATHANGI",
        "middle_name": "ANUSHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD483425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.