Individual provider Active NPI

Chandani Prabhu Ughareja, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1487116489
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023429 Issued in NY
Practice address
2475 Saint Raymonds Ave
Bronx, NY 10461-3124
Phone
(845) 565-3700
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023429 NY Primary

Addresses

Primary practice location

2475 Saint Raymonds Ave
Bronx, NY 10461-3124

Mailing address

484 Temple Hill Rd
New Windsor, NY 12553-5557

Other practice location 1

12 N 7th Ave
Mount Vernon, NY 10550-2026
Phone (845) 565-3700 ext. 214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190429000054 NY Practitioner - Physician Assistant 3072855808 Reassigns benefits to 1 organization
I20210430000113 NJ Practitioner - Physician Assistant 3072855808 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: cughareja826377@ahs.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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1487116489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 TEMPLE HILL RD",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 SAINT RAYMONDS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613124",
            "telephone_number": "845-565-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 N 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "NY",
            "postal_code": "105502026",
            "country_code": "US",
            "telephone_number": "845-565-3700 x214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UGHAREJA",
        "first_name": "CHANDANI",
        "middle_name": "PRABHU",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.