Provider Passport Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

PROVIDER PASSPORT INC.

Practice address

16192 Coastal Hwy
Lewes, DE 19958-3608

Phone

(917) 456-9261

NPI assigned

Jun 17, 2024

Organization subpart

No

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

Authorized official

Name

Harman Dhawan

Title

President

Phone

(917) 456-9261

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1174366124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16192 COASTAL HWY",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199583608",
            "telephone_number": "917-456-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16192 COASTAL HWY",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199583608",
            "telephone_number": "917-456-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER PASSPORT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "DHAWAN",
        "authorized_official_first_name": "HARMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-456-9261"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Lewes, DE
• Providers in Lewes, DE by specialty
• Health Maintenance Organization in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.