NPIMap

Organization Active NPI

Premiere Health Management

  • Anesthesiology Physician
  • North Bethesda, MD
National Provider Identifier
1235367301
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D0055302 Issued in MD
Legal business name
PREMIERE HEALTH MANAGEMENT
Practice address
3200 Tower Oaks Blvd
Suite 100
North Bethesda, MD 20852-4216
Phone
(301) 770-1711
Fax
(301) 770-1624
NPI assigned
Jun 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Authorized official

Name
Dr. Sanjay Prasad, M.D.
Title
Owner/Medical Director
Phone
(301) 770-1711

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X D0055302 MD Primary
Pediatric Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP3000X D0055302 MD

Addresses

Primary practice location

3200 Tower Oaks Blvd
Suite 100
North Bethesda, MD 20852-4216

Mailing address

3200 Tower Oaks Blvd
Suite 100
North Bethesda, MD 20852-4216
Phone (301) 770-1711

Other identifiers 3

IdentifierTypeStateIssuer
660309200MedicaidMD
4409810MedicaidDC
5702801MedicaidVA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1235367301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 TOWER OAKS BLVD",
            "address_2": "SUITE 100",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208524216",
            "telephone_number": "301-770-1711",
            "fax_number": "301-770-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 TOWER OAKS BLVD",
            "address_2": "SUITE 100",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208524216",
            "telephone_number": "301-770-1711",
            "fax_number": "301-770-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE HEALTH MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "PRASAD",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-770-1711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0055302",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MD",
            "license": "D0055302",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660309200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4409810",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5702801",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.