Individual provider Active NPI

Pooja Nanavati

  • Emergency Medicine Physician
  • Baltimore, MD
National Provider Identifier
1164832028
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
131540 Issued in FL
Practice address
110 S Paca St
Sixth Floor, Suite 200
Baltimore, MD 21201-1642
Phone
(410) 328-9400
NPI assigned
Apr 30, 2014
Last updated
Jun 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 131540 FL Primary

Addresses

Primary practice location

110 S Paca St
Sixth Floor, Suite 200
Baltimore, MD 21201-1642

Mailing address

110 S Paca St
Sixth Floor, Suite 200
Baltimore, MD 21201-1642
Phone (410) 328-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170523002517 FL Practitioner - Emergency Medicine 5193092120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Bay Emergency Physicians-Heartland LLCGroup PAC ID 0749577781, 45 clinicians

Practice addresses (Care Compare)

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (863) 314-4466

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.12 of 100Reported as group
Quality
83.29
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
131540FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Emergency Physicians LLC Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients

Locations

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

7171 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 558-8001

1395 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 942-5000

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1164832028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "SIXTH FLOOR, SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "SIXTH FLOOR, SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANAVATI",
        "first_name": "POOJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "131540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.