Individual provider Active NPI

Pooja Patil

  • Physician Assistant
  • Bel Air, MD
National Provider Identifier
1104201904
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C05851 Issued in MD
Practice address
5 Bel Air South Pkwy Ste 1535
Bel Air, MD 21015-3816
Phone
(410) 569-0044
Fax
(410) 569-2331
NPI assigned
Jul 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C05851 MD Primary

Addresses

Primary practice location

5 Bel Air South Pkwy Ste 1535
Bel Air, MD 21015-3816

Mailing address

1920 Thomas Run Cir
Bel Air, MD 21015-1581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160822001731 MD Practitioner - Physician Assistant 9830484443 Reassigns benefits to 3 organizations
I20171228001611 DC Practitioner - Physician Assistant 9830484443 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Urgent Care LLC 300 clinicians

Practice addresses (Care Compare)

11915 Georgia Ave
Wheaton, MD 20902-2065
Phone (301) 942-4505

12 Medstar Blvd
Bel Air, MD 21015-1798
Phone (410) 877-8087

4507 Stanford St
Bethesda, MD 20815-5205
Phone (443) 302-9258

6317 York Rd
Baltimore, MD 21212-2310
Phone (443) 777-6890

6500 Baltimore National Pike
Catonsville, MD 21228-4200
Phone (410) 807-8067

7825 York Rd
Towson, MD 21204-7445
Phone (443) 332-4353

8125 Ritchie Hwy
Suite H
Pasadena, MD 21122-6925
Phone (410) 544-2075

8605 Ridgelys Choice Dr
Nottingham, MD 21236-2953
Phone (410) 248-2310

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C05851MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County Health Services, Inc CurrentSince Oct 1, 2020 Accepting new patients
Medstar Urgent Care, LLC CurrentSince May 15, 2022 Accepting new patients
MNR Industries LLC CurrentSince Jun 22, 2016 Accepting new patients
MNR Industries, LLC CurrentSince Oct 21, 2017 Accepting new patients
Medstar Urgent Care LLC CurrentSince May 15, 2022 Accepting new patients
Medstar Urgent Care LLC CurrentSince May 15, 2022 Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Jun 22, 2016 Accepting new patients

Locations

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

5 Bel Air South Pkwy
Ste 1535
Bel Air, MD 21015
Phone (410) 569-0044

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

123 Singerly Ave
Elkton, MD 21921
Phone (410) 392-2686

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

Organizations & group practices 11

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1104201904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 THOMAS RUN CIR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210151581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BEL AIR SOUTH PKWY STE 1535",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210153816",
            "telephone_number": "410-569-0044",
            "fax_number": "410-569-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIL",
        "first_name": "POOJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C05851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.