Individual provider Active NPI

Anita Bhandari, MD

  • Pediatric Pulmonology Physician
  • Philadelphia, PA
National Provider Identifier
1679545461
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
MD064719L Issued in PA
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone
(215) 590-3749
Fax
(215) 590-3500
NPI assigned
Feb 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X MD064719L PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104

Mailing address

100 E Penn SQ
Wanamaker Building 9TH FLR
Philadelphia, PA 19107
Phone (267) 425-9200

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9440

Other identifiers 4

IdentifierTypeStateIssuer
0017418840008MedicaidPA
0017418840009MedicaidPA
524394OtherPAMEDICARE
0017418840002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160901001088 PA Practitioner - Pulmonary Disease 4688578016 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD064719LPAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childen'S Health Care Associates Inc. CurrentSince Jul 1, 2016 Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childrens Health Care Associates, Inc Pediatric Pulmonology CurrentSince Jul 1, 2016 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients
Childrens Health Care Associates of New Jersey PC Past Accepting new patients

Locations

500 W Butler Ave
Chalfont, PA 18914
Phone (215) 997-5730

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

Interoperability endpoints

  • Direct secure messaging: abhandari2638@connecticutchildrens.direct-ci.com

Organizations & group practices 5

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1679545461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "WANAMAKER BUILDING 9TH FLR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "267-425-9200",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-3749",
            "fax_number": "215-590-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-9440",
            "fax_number": "860-545-9445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHANDARI",
        "first_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "PA",
            "license": "MD064719L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017418840008",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017418840009",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "524394",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017418840002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.