Active NPI
Sanju Dhital
- Physician Assistant
- Providence, RI
National Provider Identifier
1659915221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 024399
- Practice address
- 15 Tew PL
Providence, RI 02906-1721 - Phone
- (401) 533-7208
- NPI assigned
- Nov 6, 2019
- Last updated
- Nov 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 024399 | NY | Primary |
Addresses
Primary practice location
15 Tew PL
Providence, RI 02906-1721
Mailing address
15 Tew PL
Providence, RI 02906-1721
Phone (401) 533-7208
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200323002734 | NY | Order and Referring Only - Physician Assistant | 6103254214 |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5820 Owens Dr BLDG E 2ND Floor
Pleasanton, CA 94588-3900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- sdhital847764@nychhc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572998400000",
"number": "1659915221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 TEW PL",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029061721",
"telephone_number": "401-533-7208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 TEW PL",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029061721",
"telephone_number": "401-533-7208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DHITAL",
"first_name": "SANJU",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-06",
"last_updated": "2019-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "024399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.