Individual provider Active NPI

Ram I Chandra, M.D.

  • Pediatric Gastroenterology Physician
  • Bethel Park, PA
National Provider Identifier
1689670440
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD019008E Issued in PA
Practice address
1300 Oxford Drive Suite LLB
Children's Hospital of Pittsburgh of Upmc
Bethel Park, PA 15102
Phone
(412) 692-3143
Fax
(412) 692-8848
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X MD019008E PA Primary

Addresses

Primary practice location

1300 Oxford Drive Suite LLB
Children's Hospital of Pittsburgh of Upmc
Bethel Park, PA 15102

Mailing address

1517 Fox Chase LN
Pittsburgh, PA 15241-3147
Phone (412) 257-2040

Other identifiers 2

IdentifierTypeStateIssuer
MD019008EOtherPAMEDICAL LICENSE
00657507001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160229001499 CA Order and Referring Only - GastroenterologyPractitioner - GastroenterologyPractitioner - Pediatric Medicine 8123190089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD019008EPAMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1689670440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 FOX CHASE LN",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152413147",
            "telephone_number": "412-257-2040",
            "fax_number": "412-257-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 OXFORD DRIVE SUITE LLB",
            "address_2": "CHILDREN'S HOSPITAL OF PITTSBURGH OF UPMC",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "15102",
            "telephone_number": "412-692-3143",
            "fax_number": "412-692-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRA",
        "first_name": "RAM",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "PA",
            "license": "MD019008E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD019008E",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00657507001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel Park, PA

Sources for this page

Verify at the official NPI Registry.