Elyse O Kharbanda, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

105050 Issued in MN

Practice address

8450 Seasons Pkwy - Mail Stop 32900a
Healthpartners Woodbury Clinic
Woodbury, MN 55125-4402

Phone

(651) 702-5300

Fax

(651) 702-5305

NPI assigned

May 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Children'S Hospital Pediatric Associates, Inc

  • Pediatrics Physician
  • Boston, MA
  • NPI 1457306664
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1487612164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5375",
            "fax_number": "651-702-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 SEASONS PKWY - MAIL STOP 32900A",
            "address_2": "HEALTHPARTNERS WOODBURY CLINIC",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254402",
            "telephone_number": "651-702-5300",
            "fax_number": "651-702-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHARBANDA",
        "first_name": "ELYSE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "105050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICAL LICENSE (TEMPORARY)",
            "identifier": "105050",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Kershaw, LPCC
• Erik Kersten, LPCC
• Jaime L Kessler, PHARMD
• Erin Keto-Sherman
• Courtney Ketola
• Hoa Huynh Khatib, RPH
• Daniel J Khoury, MD
• Joel Kiefer
• Douglas F Kilgore, OD
• Jill Noelle Kiltie, LICSW

• Pediatrics Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.