Individual provider Active NPI

Sandhya Thakallapali, M.D.

  • Family Medicine Physician
  • Vineland, NJ
National Provider Identifier
1710128046
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA08538300 Issued in NJ
Practice address
319 W Landis Ave
Vineland, NJ 08360-8101
Phone
(856) 451-4700
Fax
(856) 451-8685
NPI assigned
Mar 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA08538300 NJ Primary

Addresses

Primary practice location

319 W Landis Ave
Vineland, NJ 08360-8101

Mailing address

53 S Laurel St
Floor 2
Bridgeton, NJ 08302-1946
Phone (856) 451-4700

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100226000429 MD Practitioner - HospitalistPractitioner - Family Practice 1456402502 Reassigns benefits to 1 organization
I20140304001295 DC Practitioner - Family Practice 1456402502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Maryland PCGroup PAC ID 8729138003, 71 clinicians

Practice addresses (Care Compare)

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3300

Hospital & facility affiliations

  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08538300NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Maryland PC Family Medicine CurrentSince Aug 1, 2015 Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Family Medicine CurrentSince Aug 1, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

400 W 7th St
#H
Frederick, MD 21701
Phone (240) 566-3300

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

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 1

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": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237248000000",
    "number": "1710128046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 S LAUREL ST",
            "address_2": "FLOOR 2",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083021946",
            "telephone_number": "856-451-4700",
            "fax_number": "856-451-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083608101",
            "telephone_number": "856-451-4700",
            "fax_number": "856-451-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKALLAPALI",
        "first_name": "SANDHYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08538300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.