Individual provider Active NPI

Monica Hargovind Mirchandani, DO

  • Pediatrics Physician
  • Fort Polk, LA
National Provider Identifier
1881607265
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
235811 Issued in NY
Practice address
1585 3Rd St
Fort Polk, LA 71459-5102
Phone
(337) 531-3773
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 235811 NY Primary

Addresses

Primary practice location

1585 3Rd St
Fort Polk, LA 71459-5102

Mailing address

65 Ludwig LN
Staten Island, NY 10303-2110
Phone (646) 645-2562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161109001478 NY Practitioner - Pediatric Medicine 1557508702 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Washington Emergency Physicians, Inc. Past Accepting new patients
The Children's Aid Society Past Accepting new patients
The Children's Aid Society PastSince Feb 27, 2022 Accepting new patients

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881607265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 LUDWIG LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032110",
            "telephone_number": "646-645-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 3RD ST",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595102",
            "telephone_number": "337-531-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRCHANDANI",
        "first_name": "MONICA",
        "middle_name": "HARGOVIND",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "235811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Polk, LA

Sources for this page

Verify at the official NPI Registry.