Individual provider Active NPI

Khatchadour Bedros Palandjian, M.D.

  • Psychiatry Physician
  • Peckville, PA
National Provider Identifier
1609893254
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD035887-L Issued in PA
Practice address
202 Carol Rd
Peckville, PA 18452-1402
Phone
(570) 383-3430
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD035887-L PA Primary

Addresses

Primary practice location

202 Carol Rd
Peckville, PA 18452-1402

Mailing address

202 Carol Rd
Peckville, PA 18452-1402
Phone (570) 383-3430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD035887-LPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Rehabilitation Associates, PC Past Accepting new patients
Wayne Woodlands Manor Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609893254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CAROL RD",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184521402",
            "telephone_number": "570-383-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CAROL RD",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184521402",
            "telephone_number": "570-383-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALANDJIAN",
        "first_name": "KHATCHADOUR",
        "middle_name": "BEDROS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD035887-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peckville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.