Provider Demographics
NPI:1528012408
Name:ANNE, NIRUPAMA (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:NIRUPAMA
Middle Name:
Last Name:ANNE
Suffix:
Gender:F
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:800-243-1455
Practice Address - Street 1:30 HOPE DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2036
Practice Address - Country:US
Practice Address - Phone:717-531-8887
Practice Address - Fax:717-531-4974
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047010208600000X, 2086X0206X
NY238858208600000X, 2086X0206X
SC886812086X0206X
PAMD4876312086X0206X
MN78112208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010047010CT01OtherANTHEM BCBS
NY02770854Medicaid
CT06-1406459OtherPRIVATE HEALTHCARE SYSTEMS
CT7966939OtherAETNA
CT06-1406459OtherMULTIPLAN
CT06-1406459OtherGREAT WEST HEALTHCARE
CTP3936800OtherOXFORD
CT0303481OtherCIGNA
CT06-1406459OtherUNITED HEALTHCARE
CT06-1406459OtherWELLCARE
CT06-1406459OtherPIONEER
CT06-1406459OtherNORTHEAST HEALTH DIRECT
CT06-1406459OtherCOMMUNITY HEALTH NETWORK
CT06-1406459OtherTRICARE
CT1528012408Medicaid
CT047010OtherCONNECTICARE
CT3V1366OtherHEALTH NET
CT44721OtherHEALTH NEW ENGLAND
CT0303481OtherCIGNA
NYJ400021475Medicare PIN