Individual provider Active NPI

Amitabh Chandra, M.D.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1316237431
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D79781 Issued in MD
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-6029
NPI assigned
Apr 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X D79781 MD Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

4802 10TH Ave
Brooklyn, NY 11219-2916

Other names 1

  • Amit Chandra Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150826000977 MD Practitioner - Emergency Medicine 8729307665 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D79781MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Maryland-Frederick PC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Grace Medical Center, Inc. Current Accepting new patients
Grace Medical Center, Inc. CurrentSince Jul 13, 2015 Accepting new patients
Grace Medical Center, Inc. CurrentSince Jul 13, 2015 Accepting new patients
University of Maryland Midtown Health Inc CurrentSince May 2, 2018 Accepting new patients
University of Maryland Emergency Medicine Associates, PA Emergency Medicine CurrentSince Jul 15, 2015 Accepting new patients
West Baltimore Emergency Medicine Physicians, LLC Emergency Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2000 W Baltimore St
Baltimore, MD 21223
Phone (410) 362-3075

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

105 Penn St
Baltimore, MD 21201
Phone (410) 328-2387

821 N Eutaw St
Baltimore, MD 21201
Phone (410) 225-9185

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

Organizations & group practices 8

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1316237431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRA",
        "first_name": "AMITABH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D79781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMIT",
            "last_name": "CHANDRA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.