Individual provider Active NPI

Nandita Sanjay Sugandhi, M.D.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1407098726
Registry record updated Jul 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
236909 Issued in NY
Practice address
1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716
Phone
(212) 523-6500
Fax
(212) 523-5677
NPI assigned
Apr 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 236909 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716

Mailing address

1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716
Phone (212) 523-6500

Other identifiers 1

IdentifierTypeStateIssuer
03825985MedicaidNY

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
I20140604001060 NY Practitioner - Pediatric Medicine 0446474837 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236909NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2017 Accepting new patients
Bronxcare Health System Pediatrics CurrentSince Jan 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2017 Accepting new patients
Bronxcare Health System CurrentSince Jan 1, 2022 Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1111 Amsterdam Ave
Fl 3
New York, NY 10025
Phone (212) 523-3610

Organizations & group practices 6

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": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436140800000",
    "number": "1407098726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "SCRYMSER 3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-6500",
            "fax_number": "212-523-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "SCRYMSER 3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-6500",
            "fax_number": "212-523-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGANDHI",
        "first_name": "NANDITA",
        "middle_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2015-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "236909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03825985",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.