Individual provider Active NPI

Anjali Budhathoki, M.D

  • Hematology & Oncology Physician
  • Green Bay, WI
National Provider Identifier
1548558166
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
316716 Issued in NY
Practice address
1580 Commanche Ave
Green Bay, WI 54313-5751
Phone
(920) 435-8326
NPI assigned
Jul 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 248906 MA
Hematology & Oncology Physician 207RH0003X 83449-20 WI
Hematology & Oncology Physician 207RH0003X 316716 NY Primary

Addresses

Primary practice location

1580 Commanche Ave
Green Bay, WI 54313-5751

Mailing address

3722 82ND St
Jackson Heights, NY 11372-7040
Phone (718) 879-1600

Other practice location 1

3015 3rd Ave SE
Aberdeen, SD 57401-5418
Phone (605) 226-5500

Other practice location 2

3014 Crescent St
Astoria, NY 11102-3249
Phone (718) 808-7777

Other practice location 3

2520 30th Ave
Astoria, NY 11102-2448
Phone (718) 808-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, WI2 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
I20171121000168 SD Practitioner - Hematology/Oncology 5890052252 Reassigns benefits to 1 organization
I20240724000209 WI Practitioner - Hematology/Oncology 5890052252 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, 217 clinicians

Practice addresses (Care Compare)

1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 435-8326

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
  • Bellin Health Oconto Hospital Hospital, Oconto, WI, CCN 521356
  • Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248906MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network CurrentSince Sep 12, 2017 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Jun 4, 2024 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jun 4, 2024 Accepting new patients
Sanford Health Network Current Accepting new patients
Sanford Health Network CurrentSince Sep 12, 2017 Accepting new patients
Bellin Memorial Hospital Inc Internal Medicine CurrentSince Jun 4, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jun 4, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine Past Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

1580 Commanche Ave
Green Bay, WI 54313
Phone (920) 431-5687

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: abudhathoki339010@direct.thedacare.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1548558166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3722 82ND ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727040",
            "telephone_number": "718-879-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 COMMANCHE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135751",
            "telephone_number": "920-435-8326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 3rd Ave SE",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574015418",
            "country_code": "US",
            "telephone_number": "605-226-5500",
            "fax_number": "605-226-5601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3014 Crescent St",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111023249",
            "country_code": "US",
            "telephone_number": "718-808-7777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2520 30th Ave",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111022448",
            "country_code": "US",
            "telephone_number": "718-808-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUDHATHOKI",
        "first_name": "ANJALI",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-17",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "248906",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "83449-20",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "316716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.