Individual provider Active NPI

Puniya Khatiwada, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • York, PA
National Provider Identifier
1487946562
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD458698 Issued in PA
Practice address
292 Saint Charles Way
York, PA 17402-4648
Phone
(717) 851-6231
Fax
(717) 741-1719
NPI assigned
May 9, 2011
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD458698 PA Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0101267875 VA

Addresses

Primary practice location

292 Saint Charles Way
York, PA 17402-4648

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160912001038 PA Practitioner - EndocrinologyPractitioner - Internal Medicine 4284864448 Reassigns benefits to 1 organization
I20221114002142 DC Practitioner - Endocrinology 4284864448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

292 Saint Charles Way
York, PA 17402-4648
Phone (717) 851-6040

296 St Charles Way
York, PA 17402-4648

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Aug 3, 2022 Accepting new patients
Wellspan Medical Group CurrentSince Mar 25, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Aug 3, 2022 Accepting new patients
Wellspan Medical Group CurrentSince Mar 25, 2024 Accepting new patients
Wellspan Medical Group Current Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

292 Saint Charles Way
York, PA 17402
Phone (717) 851-6231

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

601 Memory Ln
#601
York, PA 17402

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

200 Park Ave
Falls Church, VA 22046
Phone (571) 634-3636

Interoperability endpoints

  • Direct secure messaging: pkhatiwada410024@wellspan.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1487946562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 SAINT CHARLES WAY",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174024648",
            "telephone_number": "717-851-6231",
            "fax_number": "717-741-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIWADA",
        "first_name": "PUNIYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD458698",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101267875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.