NPIMap

Individual provider Active NPI

Anmol Gupta Bansal, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1952643785
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
289216-01 Issued in NY
Practice address
1468 Madison Ave
New York, NY 10029-6508
Phone
(732) 208-1415
NPI assigned
Mar 19, 2013
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 0101266358 VA
Diagnostic Radiology Physician 2085R0202X 61323091 WA
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 289216-01 NY Primary

Addresses

Primary practice location

1468 Madison Ave
New York, NY 10029-6508

Mailing address

719 Northview St
Bellingham, WA 98226-4600
Phone (732) 208-1415

Other practice location 1

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abansal51743@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221220000374 NY Practitioner - Diagnostic Radiology 9931343225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rutgers, Robert Woood Johnson Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fpa Hospital BasedGroup PAC ID 4789826694, 423 clinicians

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-6426

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
289216-01NYMDDiagnostic Radiology Physician
61323091WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based CurrentSince Jan 1, 2023 Accepting new patients
University of Virginia Physicians Group Past Accepting new patients

Locations

5 Cuba Hill Rd
Greenlawn, NY 11740
Phone (631) 628-5000

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: abansal51743@direct.carilionclinic.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1952643785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 NORTHVIEW ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982264600",
            "telephone_number": "732-208-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "732-208-1415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Belleview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141838",
            "country_code": "US",
            "telephone_number": "540-981-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "ANMOL",
        "middle_name": "GUPTA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "VA",
            "license": "0101266358",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "61323091",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "289216-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abansal51743@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "abansal51743@direct.carilionclinic.org",
            "address_1": "1906 Belleview Ave SE",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240141838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.