Healthcare Provider Details
I. General information
NPI: 1528012408
Provider Name (Legal Business Name): NIRUPAMA ANNE M.D., F.A.C.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 HOPE DR
HERSHEY PA
17033-2036
US
IV. Provider business mailing address
500 UNIVERSITY DR
HERSHEY PA
17033-2360
US
V. Phone/Fax
- Phone: 717-531-8887
- Fax: 717-531-4974
- Phone:
- Fax: 800-243-1455
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 047010 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 238858 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | 047010 |
| License Number State | CT |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | 238858 |
| License Number State | NY |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | 88681 |
| License Number State | SC |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | MD487631 |
| License Number State | PA |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 78112 |
| License Number State | MN |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 010047010CT01 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | ANTHEM BCBS |
| # 2 | |
| Identifier | 02770854 |
| Identifier Type | MEDICAID |
| Identifier State | NY |
| Identifier Issuer | |
| # 3 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | PRIVATE HEALTHCARE SYSTEMS |
| # 4 | |
| Identifier | 7966939 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | AETNA |
| # 5 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | MULTIPLAN |
| # 6 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | GREAT WEST HEALTHCARE |
| # 7 | |
| Identifier | P3936800 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | OXFORD |
| # 8 | |
| Identifier | 0303481 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | CIGNA |
| # 9 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | UNITED HEALTHCARE |
| # 10 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | WELLCARE |
| # 11 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | PIONEER |
| # 12 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | NORTHEAST HEALTH DIRECT |
| # 13 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | COMMUNITY HEALTH NETWORK |
| # 14 | |
| Identifier | 06-1406459 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | TRICARE |
| # 15 | |
| Identifier | 1528012408 |
| Identifier Type | MEDICAID |
| Identifier State | CT |
| Identifier Issuer | |
| # 16 | |
| Identifier | 047010 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | CONNECTICARE |
| # 17 | |
| Identifier | 3V1366 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | HEALTH NET |
| # 18 | |
| Identifier | 44721 |
| Identifier Type | OTHER |
| Identifier State | CT |
| Identifier Issuer | HEALTH NEW ENGLAND |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
