Individual provider Active NPI

Pragyashree Sharma Basyal, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1104531342
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0008766 Issued in MD
Practice address
1235 E Monument St
Baltimore, MD 21202-5327
Phone
(443) 303-7076
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X C0008766 MD
Physician Assistant 363A00000X C0008766 MD Primary

Addresses

Primary practice location

1235 E Monument St
Baltimore, MD 21202-5327

Mailing address

4421 Glenmore Ave
Baltimore, MD 21206-2010
Phone (443) 303-7076

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230307002488 MD Practitioner - Physician Assistant 5294108569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hollis Seunarine Mdpa LLCGroup PAC ID 4183608573, 19 clinicians

Practice addresses (Care Compare)

1235 E Monument St
Jai Medical Center
Baltimore, MD 21202-5327
Phone (410) 327-5100

5010 York Rd
Baltimore, MD 21212-4444
Phone (410) 433-2200

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1104531342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 GLENMORE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212062010",
            "telephone_number": "443-303-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E MONUMENT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212025327",
            "telephone_number": "443-303-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA BASYAL",
        "first_name": "PRAGYASHREE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MD",
            "license": "C0008766",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.