NPIMap

Individual provider Active NPI

Avanija Kanmanthareddy, MD

  • Gastroenterology Physician
  • York, PA
National Provider Identifier
1447633201
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD484938 Issued in PA
Practice address
2690 Southfield Dr Ste a
York, PA 17403-4510
Phone
(717) 741-1414
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7496 NE
Gastroenterology Physician 207RG0100X 31026 NE
Gastroenterology Physician 207RG0100X MD484938 PA Primary

Addresses

Primary practice location

2690 Southfield Dr Ste a
York, PA 17403-4510

Mailing address

2690 Southfield Dr Ste a
York, PA 17403-4510
Phone (717) 741-1414

Other practice location 1

7710 Mercy Rd Ste 2000
Omaha, NE 68124-2323
Phone (402) 717-9800

Other names 1

  • Avanija Buddam Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241007002911 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 9133417009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

2690 Southfield Dr
York, PA 17403-4510
Phone (717) 741-1414

Hospital & facility affiliations

  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy28
Upper gastrointestinal (GI) endoscopy for acid reflux56

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services Gastroenterology CurrentSince Sep 1, 2024 Accepting new patients
Pinnacle Health Medical Services CurrentSince Sep 1, 2024 Accepting new patients
Pinnacle Health Medical Services Internal Medicine Current Accepting new patients
Alegent Creighton Clinic Internal Medicine Past Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

2690 Southfield Dr
York, PA 17403
Phone (717) 741-1414

2690 Southfield Dr
#A
York, PA 17403
Phone (717) 741-1414

Interoperability endpoints

  • Direct secure messaging: akanmanthareddy437104@upmc.direct-ci.com

Organizations & group practices 4

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 7

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1447633201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 SOUTHFIELD DR STE A",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034510",
            "telephone_number": "717-741-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 SOUTHFIELD DR STE A",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034510",
            "telephone_number": "717-741-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7710 Mercy Rd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681242323",
            "country_code": "US",
            "telephone_number": "402-717-9800",
            "fax_number": "402-717-6068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANMANTHAREDDY",
        "first_name": "AVANIJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "7496",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NE",
            "license": "31026",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD484938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVANIJA",
            "last_name": "BUDDAM",
            "credential": "MBBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.