Active NPI
Ananthi Rajamoorthi, MD, PHD
- Pediatric Gastroenterology Physician
- Philadelphia, PA
National Provider Identifier
1760010375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- MT228531
- Practice address
- 3401 Civic Center Blvd,
Division of Pediatric Gastroenterology
Philadelphia, PA 19104 - Phone
- (267) 425-2739
- NPI assigned
- Mar 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Gastroenterology Physician | 2080P0206X | MT228531 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd,
Division of Pediatric Gastroenterology
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd
Division of Pediatric Gastroenterology
Philadelphia, PA 19104
Phone (267) 425-2739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT228531 | PA | MD | Pediatric Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687478400000",
"number": "1760010375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF PEDIATRIC GASTROENTEROLOGY",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "267-425-2739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD,",
"address_2": "DIVISION OF PEDIATRIC GASTROENTEROLOGY",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "267-425-2739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJAMOORTHI",
"first_name": "ANANTHI",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-30",
"last_updated": "2023-06-23",
"certification_date": "2023-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "PA",
"license": "MT228531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.