NPIMap

Individual provider Active NPI

Supriya Mathur Gianchandani, MD

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1508801044
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5042 Issued in AK
Practice address
4315 Diplomacy Dr
Attn: Sherry Reedy
Anchorage, AK 99508-5926
Phone
(907) 729-3971
Fax
(907) 729-1542
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X C54613 CA
Family Medicine Physician 207Q00000X 5042 AK Primary

Addresses

Primary practice location

4315 Diplomacy Dr
Attn: Sherry Reedy
Anchorage, AK 99508-5926

Mailing address

1050 Pacific Coast Highway
Kaiser South Bay
Harbor City, CA 90710
Phone (310) 517-3174

Other practice location 1

20911 Earl St Ste 470
Torrance, CA 90503-4355
Phone (310) 372-0700

Other identifiers 1

IdentifierTypeStateIssuer
MD6864MedicaidAK

Other names 1

  • Supriya Mathur Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040716000380 TX Practitioner - Otolaryngology 1759284367 Reassigns benefits to 2 organizations
I20111215000682 CA Practitioner - Otolaryngology 1759284367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Steven E Davis MD IncGroup PAC ID 4688691512, 4 clinicians
Southeast Alaska Regional Health ConsortiumGroup PAC ID 1456265362, 373 clinicians

Practice addresses (Care Compare)

20911 Earl St
Suite 470
Torrance, CA 90503-4355
Phone (310) 372-0700

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

Hospital & facility affiliations

  • Southeast Alaska Regional Health Consortium Hospital, Sitka, AK, CCN 021314
  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5042AKMDFamily Medicine Physician
C54613CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince May 2, 2016 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince May 1, 2017 Accepting new patients
Steven E Davis MD Inc Otolaryngology CurrentSince Oct 1, 2023 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince May 1, 2017 Accepting new patients
Tanana Chiefs Conference Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

20911 Earl St
Ste 470
Torrance, CA 90503
Phone (310) 370-0007

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: smgianchandani@direct.anthc.org

Organizations & group practices 7

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 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1508801044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 PACIFIC COAST HIGHWAY",
            "address_2": "KAISER SOUTH BAY",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "90710",
            "telephone_number": "310-517-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "address_2": "ATTN: SHERRY REEDY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "907-729-3971",
            "fax_number": "907-729-1542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20911 Earl St Ste 470",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905034355",
            "country_code": "US",
            "telephone_number": "310-372-0700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIANCHANDANI",
        "first_name": "SUPRIYA",
        "middle_name": "MATHUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "C54613",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "5042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD6864",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUPRIYA",
            "last_name": "MATHUR",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.