NPIMap

Organization Active NPI

Sanjay Bharti MD PLLC

  • Internal Medicine Physician
  • Fairmont, WV
National Provider Identifier
1962532549
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19609 Issued in WV
Legal business name
SANJAY BHARTI MD PLLC
Practice address
51 Southland Dr Ste 2400
Fairmont, WV 26554-2247
Phone
(304) 363-3714
Fax
(304) 363-6850
NPI assigned
Mar 6, 2007
Last updated
Dec 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Rama Subba Rao Rao Kadiyala
Title
Business Strategy Manager
Phone
(304) 363-3714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19609 WV Primary

Addresses

Primary practice location

51 Southland Dr Ste 2400
Fairmont, WV 26554-2247

Mailing address

51 Southland Dr Ste 2400
Fairmont, WV 26554-2247
Phone (304) 363-3714

Other identifiers 6

IdentifierTypeStateIssuer
001811060OtherWVBS PAY TO NUMBER
110236001OtherWVRR MC
0015224000MedicaidWV
5622758OtherWVAETNA
000332087OtherWVMS BCBS
3810016962MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100303000159 WV Part B Supplier - Clinic/Group Practice 8224171251 Receives reassigned benefits from 17 practitioners
Practice locations: Bridgeport, WV; Fairmont, WV; Kingwood, WV; Mannington, WV; Morgantown, WV; Parkersburg, WV; Wheeling, WV
O20230613001016 PA Part B Supplier - Clinic/Group Practice 8224171251 Receives reassigned benefits from 4 practitioners
Practice locations: Waynesburg, PA; Uniontown, PA; Greensburg, PA

National Provider Directory

National Provider Directory

Locations

1037 Compass Cir
Ste 101
Greensburg, PA 15601
Phone (304) 363-3714

1023 Pittsburgh Rd
Ste 203
Uniontown, PA 15401
Phone (304) 363-3714

51 Southland Dr
Ste 12
Fairmont, WV 26554

51 Southland Dr
Ste 2400
Fairmont, WV 26554
Phone (304) 363-3714

411 Morgantown St
Kingwood, WV 26537
Phone (304) 329-0555

800 E Main St
Mannington, WV 26582
Phone (304) 986-2030

300 Wedgewood Dr
Morgantown, WV 26505
Phone (304) 599-8802

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1962532549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 SOUTHLAND DR STE 2400",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542247",
            "telephone_number": "304-363-3714",
            "fax_number": "304-363-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SOUTHLAND DR STE 2400",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542247",
            "telephone_number": "304-363-3714",
            "fax_number": "304-363-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANJAY BHARTI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "KADIYALA",
        "authorized_official_first_name": "RAMA SUBBA RAO",
        "authorized_official_middle_name": "RAO",
        "authorized_official_title_or_position": "BUSINESS STRATEGY MANAGER",
        "authorized_official_telephone_number": "304-363-3714"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "19609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS PAY TO NUMBER",
            "identifier": "001811060",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MC",
            "identifier": "110236001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015224000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5622758",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS BCBS",
            "identifier": "000332087",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810016962",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.