Individual provider Active NPI

Anamika Khatri-Dua, MD

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1730150004
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0064746 Issued in MD
Practice address
900 S Caton Ave
Baltimore, MD 21229-5201
Phone
(410) 368-2011
NPI assigned
Jan 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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 D0064746 MD Primary

Addresses

Primary practice location

900 S Caton Ave
Baltimore, MD 21229-5201

Mailing address

3262 Eleanors Garden Way
Woodbine, MD 21797-7520
Phone (443) 266-7034

Other identifiers 5

IdentifierTypeStateIssuer
7021669OtherNYAETNA
P020237151OtherNYBC/BS
P010237151OtherNYBLUECHOICE
MDJ124OtherNYPREFERRED CARE
02669794MedicaidNY

Other names 1

  • Anamika Khatri Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170717002088 GA Practitioner - Pediatric Medicine 8729010053 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0064746MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Oct 15, 2017 Accepting new patients
Maryland Provo-I Medical Services, PC Past Accepting new patients
Johns Hopkins Emergency Medical Past Accepting new patients
Champion Emergency Physicians LLC Past Accepting new patients
Caton Emergency Physicians Past Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

Interoperability endpoints

  • Direct secure messaging: akhatridua141550@directwellstar.org

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1730150004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3262 ELEANORS GARDEN WAY",
            "city": "WOODBINE",
            "state": "MD",
            "postal_code": "217977520",
            "telephone_number": "443-266-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S CATON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295201",
            "telephone_number": "410-368-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATRI-DUA",
        "first_name": "ANAMIKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0064746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7021669",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "P020237151",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE",
            "identifier": "P010237151",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "MDJ124",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02669794",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANAMIKA",
            "last_name": "KHATRI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.