DR. AMBIKA GNANAM CHIDAMBARAM (M.B.B.S) – Pediatric Pulmonology Physician, NPI 1831583483
Pediatric Pulmonology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,237 PEDIATRIC MEDICINE in PA
Provider Addresses for DR. AMBIKA GNANAM CHIDAMBARAM (M.B.B.S)
3401 CIVIC CENTER BLVD
DIVISION OF PEDIATRIC PULMONOLOGY
PHILADELPHIA, PA 19104
Phone: (215) 590-3498
Type: Mailing
3401 civic center blvd
Division of Pediatric Pulmonology
Philadelphia, PA 19104
Phone: (215) 590-3498
Type: Location
2040 W Charleston Blvd Ste 402
Las Vegas, NV 891022250
Phone: (702) 671-2236
Fax: (702) 671-2233
Type: Location
2521 STOCKTON BLVD FL 3
SACRAMENTO, CA 958172207
Phone: (916) 734-3112
Type: Location
2516 STOCKTON BLVD FL 3
SACRAMENTO, CA 958172208
Phone: (916) 734-3189
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-10-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221007001789 | I | Pediatric Medicine | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 19104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NY | |
| - | PA | |
| - | CA | |
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| Physician Assistant | IL | |
| Internal Medicine, Hospice/Palliative Care | CA | |
| Family Practice | CA | |
| - | CA | |
| - | CA | |
| - | CA |
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