Individual provider Active NPI

Vijaya K Agarwala, M.D.

  • Anesthesiology Physician
  • Warren, PA
National Provider Identifier
1346239993
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD057970L Issued in PA
Practice address
2 W Crescent Park
Warren, PA 16365-2111
Phone
(814) 723-3300
Fax
(814) 723-8515
NPI assigned
Oct 17, 2005
Last updated
Oct 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD057970L PA Primary

Addresses

Primary practice location

2 W Crescent Park
Warren, PA 16365-2111

Mailing address

2 W Crescent Park
Warren, PA 16365-2111
Phone (814) 723-3300

Other identifiers 2

IdentifierTypeStateIssuer
739079OtherPAHIGHMARK BLUE SHIELD
00020289904OtherNYUNIVERA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200206001435 NY Practitioner - Anesthesiology 1850553652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of New York, P.C.Group PAC ID 7719041102, 50 clinicians

Practice addresses (Care Compare)

207 Foote Ave
Jamestown, NY 14701-7077
Phone (716) 487-0141

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of New York, P.C. Anesthesiology CurrentSince Jan 2, 2020 Accepting new patients
Anesthesia Consultants of Erie, Inc. Anesthesiology Past Accepting new patients
Southern Tier Anesthesiologists PC Anesthesiology Past Accepting new patients

Locations

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1346239993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-723-3300",
            "fax_number": "814-723-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-723-3300",
            "fax_number": "814-723-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARWALA",
        "first_name": "VIJAYA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD057970L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "739079",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020289904",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.