Active NPI
Mahesh R Pandya, M.D.
- Hematology & Oncology Physician
- Deridder, LA
National Provider Identifier
1457353344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- L05773R
- Practice address
- 603 S Pine St
Deridder, LA 70634-4941 - Phone
- (337) 463-2172
- Fax
- (337) 462-3243
- NPI assigned
- Aug 11, 2005
- Last updated
- May 19, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | L05773R | LA | Primary |
Addresses
Primary practice location
603 S Pine St
Deridder, LA 70634-4941
Mailing address
603 S Pine St
Deridder, LA 70634-4941
Phone (337) 463-2172
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| POO110446 | Other | LA | RAILROAD MEDICARE |
| 1366641540 | Other | LA | NPI |
| 1320692 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L05773R | LA | MD | Hematology & Oncology Physician |
Organizations & group practices 1
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.
-
- Hematology & Oncology Physician
- Deridder, LA
- NPI 1366641540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305763200000",
"number": "1457353344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 S PINE ST",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706344941",
"telephone_number": "337-463-2172",
"fax_number": "337-462-3243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 S PINE ST",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706344941",
"telephone_number": "337-463-2172",
"fax_number": "337-462-3243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANDYA",
"first_name": "MAHESH",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2011-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "LA",
"license": "L05773R",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "POO110446",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1366641540",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1320692",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Deridder, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.