NPIMap

Individual provider Active NPI

Kanwarpreet Tandon

  • Gastroenterology Physician
  • Boston, MA
National Provider Identifier
1497117519
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
TRN19443 Issued in FL
Practice address
725 Albany St # 6
Boston, MA 02118-3549
Phone
(617) 638-6525
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 123456 MA
Internal Medicine Physician 207R00000X TRN19443 FL
Gastroenterology Physician 207RG0100X TRN19443 FL Primary

Addresses

Primary practice location

725 Albany St # 6
Boston, MA 02118-3549

Mailing address

801 Albany St FL G
Boston, MA 02119-3791
Phone (617) 414-5405

Other practice location 1

2020 59th St W
Bradenton, FL 34209-4604
Phone (941) 792-6611

Other practice location 2

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 659-5646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20230825000523 WV Practitioner - Gastroenterology 2769717412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

2175 McClellandtown Rd
Suite Aandb
Masontown, PA 15461-2593
Phone (724) 491-5220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy55
Upper gastrointestinal (GI) endoscopy for acid reflux48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123456MAMDFamily Medicine Physician
TRN19443FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jun 11, 2023 Accepting new patients
West Virginia University Medical Corporation Internal Medicine CurrentSince Jun 11, 2023 Accepting new patients
Evans Medical Foundation, Inc. Internal Medicine PastSince May 22, 2022 Accepting new patients

Locations

1325 Locust Ave
Fairmont, WV 26554
Phone (304) 367-7100

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

Interoperability endpoints

  • Direct secure messaging: kanwarpreet.tandon@hca4.eclinicaldirectplus.com

Organizations & group practices 3

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 10

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1497117519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791",
            "telephone_number": "617-414-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST # 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183549",
            "telephone_number": "617-638-6525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 59th St W",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342094604",
            "country_code": "US",
            "telephone_number": "941-792-6611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2950 Cleveland Clinic Blvd",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "33331",
            "country_code": "US",
            "telephone_number": "954-659-5646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANDON",
        "first_name": "KANWARPREET",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "123456",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN19443",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "TRN19443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.