Individual provider Active NPI

Leena Shrivastava Dev, MD

  • Pediatrics Physician
  • Frederick, MD
National Provider Identifier
1093725616
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0075515 Issued in MD
Practice address
87 Thomas Johnson Dr Ste 101
Frederick, MD 21702-4427
Phone
(301) 694-0606
Fax
(301) 662-6928
NPI assigned
Aug 8, 2006
Last updated
Nov 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301070491 MI
Pediatrics Physician 208000000X 25MA08917600 NJ
Pediatrics Physician 208000000X D0075515 MD Primary
Hospitalist Physician 208M00000X 4301070491 MI

Addresses

Primary practice location

87 Thomas Johnson Dr Ste 101
Frederick, MD 21702-4427

Mailing address

87 Thomas Johnson Dr Ste 101
Frederick, MD 21702-4427
Phone (301) 694-0606

Other identifiers 3

IdentifierTypeStateIssuer
4710765MedicaidMI
0188077MedicaidNJ
422391800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20140617000225 MD Practitioner - Pediatric Medicine 0648227041 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0075515MDMDPediatrics Physician
25MA08917600NJMDPediatrics Physician
4301070491MIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Pediatrics CurrentSince Mar 2, 2017 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Feb 17, 2014 Accepting new patients
Sinai Hospital of Baltimore, Inc CurrentSince Feb 17, 2014 Accepting new patients
Privia Medical Group, LLC CurrentSince Mar 2, 2017 Accepting new patients
SCHC Pediatric Associates, LLC Pediatrics Past Accepting new patients
Frederick Pediatric Associates P.a. Pediatrics PastSince Nov 24, 2024 Accepting new patients
Frederick Pediatric Associates P.a. Pediatrics Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

Interoperability endpoints

  • Direct secure messaging: leena.dev@fpap-md.direct.office.nextgen.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1093725616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 THOMAS JOHNSON DR STE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024427",
            "telephone_number": "301-694-0606",
            "fax_number": "301-662-6928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 THOMAS JOHNSON DR STE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024427",
            "telephone_number": "301-694-0606",
            "fax_number": "301-662-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEV",
        "first_name": "LEENA",
        "middle_name": "SHRIVASTAVA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301070491",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08917600",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0075515",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301070491",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4710765",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0188077",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422391800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.