Individual provider Active NPI

Shiva Jung Pandey

  • Student in an Organized Health Care Education/Training Program
  • Baltimore, MD
National Provider Identifier
1235738386
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
620 W Lexington St
Baltimore, MD 21201-1508
Phone
(385) 259-3070
NPI assigned
Oct 20, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

620 W Lexington St
Baltimore, MD 21201-1508

Mailing address

620 W Lexington St
Baltimore, MD 21201-1508
Phone (385) 259-3070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211005001898 DE Practitioner - Physician Assistant 1759789720 Reassigns benefits to 1 organization
I20211216002010 MD Practitioner - Physician Assistant 1759789720 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Sep 27, 2021 Accepting new patients
Christiana Care Health Services, Inc CurrentSince Sep 27, 2021 Accepting new patients
Union Hospital of Cecil County Inc CurrentSince Oct 26, 2021 Accepting new patients
Union Hospital of Cecil County CurrentSince Oct 26, 2021 Accepting new patients

Locations

4735 Ogletown Stanton Rd
Ste 3301
Newark, DE 19713
Phone (302) 623-4370

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

207 North St
Elkton, MD 21921
Phone (410) 996-8700

Organizations & group practices 5

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": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1235738386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W LEXINGTON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011508",
            "telephone_number": "385-259-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W LEXINGTON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011508",
            "telephone_number": "385-259-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDEY",
        "first_name": "SHIVA",
        "middle_name": "JUNG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.