Individual provider Active NPI

Vivek Khandelwal, M.D.

  • Internal Medicine Physician
  • Medina, OH
National Provider Identifier
1699734038
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-094324 Issued in OH
Practice address
970 E Washington St
Suite #2F
Medina, OH 44256-2181
Phone
(330) 723-7999
Fax
(330) 764-9907
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD427120 PA
Internal Medicine Physician 207R00000X 35-094324 OH Primary

Addresses

Primary practice location

970 E Washington St
Suite #2F
Medina, OH 44256-2181

Mailing address

970 E Washington St
Suite #2F
Medina, OH 44256-2181
Phone (330) 723-7999

Other identifiers 2

IdentifierTypeStateIssuer
4273911OtherOHMEDICARE PTAN
101382073MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20091015000165 OH Practitioner - Internal Medicine 5092748541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A and S Khandelwal MD IncGroup PAC ID 1850358300, 6 clinicians

Practice addresses (Care Compare)

970 E Washington St
Suite 2F
Medina, OH 44256-2181
Phone (330) 723-7999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-094324OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A & S Khandelwal MD Inc CurrentSince Sep 18, 2009 Accepting new patients
Medina Hospital Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

970 E Washington St
Ste 2F
Medina, OH 44256
Phone (330) 723-7999

Interoperability endpoints

  • Direct secure messaging: vkhandelwal@askhandelwal.medentdirect.com
  • Direct secure messaging: vkhandelwal@direct.swgeneral.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1699734038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 E WASHINGTON ST",
            "address_2": "SUITE #2F",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562181",
            "telephone_number": "330-723-7999",
            "fax_number": "330-764-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 E WASHINGTON ST",
            "address_2": "SUITE #2F",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562181",
            "telephone_number": "330-723-7999",
            "fax_number": "330-764-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDELWAL",
        "first_name": "VIVEK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD427120",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-094324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4273911",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101382073",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.