Vidya T Chande, MD
Individual provider Active NPI Pediatric Emergency Medicine (Pediatrics) Physician · Des Moines, IA
NPI 1922092030 · NPPES record last updated Apr 1, 2008
Key facts
- NPI
- 1922092030
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X
- License
- 33479 (IA)
- Practice address
- 1200 Pleasant St
Blank Childrens Hospital
Des Moines, IA 50309-1406 - Phone
- (515) 241-5926
- Fax
- (515) 241-5127
- NPI assigned
- Sep 2, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161025002385 | WA | Practitioner - Pediatric Medicine |
3779641618 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33479 | IA | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Association of Chrmc and University Physicians | Current |
Accepting new patients | |
| Association of CHMC and University Physicians | Current |
Accepting new patients |
Locations
900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080
4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000
Interoperability endpoints
- vchande35846@direct.seattlechildrens.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 33479 | IA | Yes |
Addresses
Primary practice location
1200 Pleasant St
Blank Childrens Hospital
Des Moines, IA 50309-1406
Mailing address
1200 Pleasant St
Blank Childrens Hospital
Des Moines, IA 50309-1406
Phone (515) 241-5926
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0207100 | Medicaid | IA |
Other names
- Vidya Balkrishna Sukhatme
Other providers in Des Moines, IA
- Krystal Lynn Chambers
- Quentin Chambers
- Christopher S Champion
- Andrew Wanley Chan
- Tamara S Chance
- Basaviah Chandramouli
- Prem K.G. Chandran
- Poojitha Chandrasekhar
- Angela Lynn Chaney
- Change Behavioral Health, Inc
All providers in Des Moines, IA · Pediatric Emergency Medicine (Pediatrics) Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.