Shubhang N Mazumdar, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

19297 Issued in GA

Practice address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191

Phone

(702) 653-3800

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, AZ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cogent Healthcare of Arizona PC

  • Internal Medicine Physician
  • Sierra Vista, AZ
  • NPI 1568758266
  Medicare reassignment NPD
• Banner Sun City Medical Group

  • Multi-Specialty Clinic/Center
  • Sun City, AZ
  • NPI 1902067200
  NPD (past)
• Comprehensive Hospitalist Services of Arizona LLC

  • Hospitalist Physician
  • Mesa, AZ
  • NPI 1689909780
  NPD (past)
• Hospital Authority of Wayne County Georgia

  • Hospitalist Physician
  • Jesup, GA
  • NPI 1275703985
  NPD (past)
• Hospital Authority of Wayne County Georgia

  • Certified Registered Nurse Anesthetist
  • Jesup, GA
  • NPI 1366506222
  NPD (past)
• Soliant Health

  • Contractor
  • Tucker, GA
  • NPI 1871710723
  NPD (past)
• Vitex Healthcare, PC

  • Hospitalist Physician
  • Tucker, GA
  • NPI 1205166717
  NPD (past)
• Zilmed, Inc.

  • Family Medicine Physician
  • Sellersburg, IN
  • NPI 1376574533
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1003887183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "89191",
            "telephone_number": "702-653-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "89191",
            "telephone_number": "702-653-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Windy Hill Rd SE",
            "address_2": "STE# 309",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678665",
            "country_code": "US",
            "telephone_number": "770-951-1565",
            "fax_number": "770-988-0563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUMDAR",
        "first_name": "SHUBHANG",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "42826",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "19297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000266791B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared Scott Matson, MD
• Brenda Matthews, MSW
• Eric W Maughan, M.D.
• Alexander J Mayers, MD
• Jason Mayotte-Blum, PH.D
• Kayleigh Madison McAviney, IDMT
• Natalie M McBean, PA-C
• Joshua D McCarron, M.D.
• Marianne McCartney, MD
• Willie Gene McClure III, MD

• Internal Medicine Physician in Nellis Afb, NV
• Providers in Nellis Afb, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.