Individual provider Active NPI

Anandita Tiwari, M.D.

  • Internal Medicine Physician
  • Canyonville, OR
National Provider Identifier
1992775092
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD26035 Issued in OR
Practice address
115 S Pine St
Canyonville, OR 97417-9648
Phone
(541) 839-4211
Fax
(541) 839-4983
NPI assigned
Jan 23, 2006
Last updated
Jun 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 38D2107406 OR
Internal Medicine Physician 207R00000X MD26035 OR Primary

Addresses

Primary practice location

115 S Pine St
Canyonville, OR 97417-9648

Mailing address

PO Box 888
Canyonville, OR 97417-0888
Phone (541) 839-4211

Other identifiers 1

IdentifierTypeStateIssuer
027821MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20080430000477 OR Practitioner - Internal MedicinePractitioner - General PracticePractitioner - Family Practice 0648359729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice, General Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Anna LLCGroup PAC ID 1254552839, 2 clinicians

Practice addresses (Care Compare)

115 S Pine St
Canyonville, OR 97417-9648
Phone (541) 839-4211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions51
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38D2107406ORMDClinical Medical Laboratory

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Anna LLC Internal Medicine CurrentSince Jul 15, 2014 Accepting new patients
Galen Inpatient Physicians PC Internal Medicine CurrentSince Dec 1, 2015 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Dec 1, 2015 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Organizations & group practices 3

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 3

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1992775092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888",
            "city": "CANYONVILLE",
            "state": "OR",
            "postal_code": "974170888",
            "telephone_number": "541-839-4211",
            "fax_number": "541-839-4983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S PINE ST",
            "city": "CANYONVILLE",
            "state": "OR",
            "postal_code": "974179648",
            "telephone_number": "541-839-4211",
            "fax_number": "541-839-4983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIWARI",
        "first_name": "ANANDITA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OR",
            "license": "38D2107406",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD26035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027821",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyonville, OR

Sources for this page

Verify at the official NPI Registry.