Individual provider Active NPI

Janki Ghodasara, MD

  • Anesthesiology Physician
  • Washington, DC
National Provider Identifier
1407203383
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D90238 Issued in MD
Practice address
2150 Pennsylvania Ave NW
Suite 5-416
Washington, DC 20037-3201
Phone
(704) 526-9663
NPI assigned
May 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 26292801 NC
Anesthesiology Physician 207L00000X D90238 MD Primary

Addresses

Primary practice location

2150 Pennsylvania Ave NW
Suite 5-416
Washington, DC 20037-3201

Mailing address

2424 Pennsylvania Ave NW
Apt 412
Washington, DC 20037-1746
Phone (704) 526-9663

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
I20201103000000 MD Practitioner - Anesthesiology 0648565747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Anesthesia Associates LLCGroup PAC ID 2062514888, 109 clinicians

Practice addresses (Care Compare)

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone 80051653155104

Hospital & facility affiliations

  • Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26292801NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia Maryland LLC Anesthesiology CurrentSince Aug 25, 2020 Accepting new patients
Lifebridge Anesthesia Associates, LLC Anesthesiology CurrentSince Jun 1, 2023 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1407203383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 PENNSYLVANIA AVE NW",
            "address_2": "APT 412",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371746",
            "telephone_number": "704-526-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "address_2": "SUITE 5-416",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "704-526-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHODASARA",
        "first_name": "JANKI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "26292801",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D90238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.