Individual provider Active NPI

Sri Nidhi Ganji, MD

  • Pediatrics Physician
  • Raleigh, NC
National Provider Identifier
1710327986
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2023-03528 Issued in NC
Practice address
10 Sunnybrook Rd
Raleigh, NC 27610-1808
Phone
(919) 212-7000
NPI assigned
Jul 2, 2013
Last updated
Jul 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2023-03528 NC Primary

Addresses

Primary practice location

10 Sunnybrook Rd
Raleigh, NC 27610-1808

Mailing address

10 Sunnybrook Rd
Raleigh, NC 27610-1808
Phone (919) 212-7000

Other identifiers 2

IdentifierTypeStateIssuer
103322388MedicaidPA
04817992MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA, NC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170828000821 NY Practitioner - Pediatric Medicine 8022380955 Reassigns benefits to 2 organizations
I20190502002995 PA Practitioner - Pediatric Medicine 8022380955 Reassigns benefits to 1 organization
I20240925001221 NC Practitioner - Pediatric Medicine 8022380955 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Nov 1, 2022 Accepting new patients
Olean General Hospital Pediatrics CurrentSince Sep 1, 2017 Accepting new patients
Olean General Hospital Pediatrics CurrentSince Apr 1, 2019 Accepting new patients
Olean Medical Practice PLLC Current Accepting new patients
County of Wake Current Accepting new patients
Olean General Hospital Current Accepting new patients
General Physician, PC CurrentSince Nov 1, 2022 Accepting new patients
County of Wake CurrentSince Jul 16, 2024 Accepting new patients
County of Wake CurrentSince Jul 16, 2024 Accepting new patients

Locations

10 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 250-4570

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

2666 W State St
Olean, NY 14760
Phone (716) 701-1700

535 Main St
Olean, NY 14760
Phone (716) 372-0141

535 Main St
Ste 1
Olean, NY 14760
Phone (716) 372-0141

4039 Route 219
Ste 101
Salamanca, NY 14779
Phone (716) 945-0361

116 Interstate Pkwy
Ste 42
Bradford, PA 16701
Phone (814) 362-8390

200 Pleasant St
Bradford, PA 16701
Phone (814) 362-8293

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6edd93a1-7391-4938-bcd9-ebe248fd573e/
  • Direct secure messaging: sriganji@healthsystemphysicianpc.medentdirect.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1710327986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SUNNYBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101808",
            "telephone_number": "919-212-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SUNNYBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101808",
            "telephone_number": "919-212-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANJI",
        "first_name": "SRI NIDHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2023-03528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103322388",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04817992",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.