Individual provider Active NPI

Nahla Chaudhary

  • Oral and Maxillofacial Surgery (Dentist)
  • Martinsburg, WV
National Provider Identifier
1255544748
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
50 054322 Issued in NY
Practice address
1007 Sushruta Dr
Martinsburg, WV 25401-8876
Phone
(304) 263-0991
Fax
(304) 274-9546
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 50 054322 NY Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3881 WV
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 14553 MD

Addresses

Primary practice location

1007 Sushruta Dr
Martinsburg, WV 25401-8876

Mailing address

1007 Sushruta Dr
Martinsburg, WV 25401-8876
Phone (304) 263-0991

Other identifiers 1

IdentifierTypeStateIssuer
3810015183MedicaidWV

Other names 1

  • Dr. Nahla Choudhary Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090923000445 WV Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 1355497934 Reassigns benefits to 1 organization
I20150212000110 MD Practitioner - Maxillofacial Surgery 1355497934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
New York University College of Dentistry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Oral and Maxillofacial Surgeons, PCGroup PAC ID 1355243544, 3 clinicians

Practice addresses (Care Compare)

1007 Sushruta Dr
Martinsburg, WV 25401-8800
Phone 3042630991205

1144 Opal CT
Hagerstown, MD 21740-5940
Phone (301) 733-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14553MDMDClinical Social Worker
50 054322NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Oral & Maxillofacial Surgeons, PC Oral and Maxillofacial Surgery CurrentSince Jul 19, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6550 Mercantile Dr E
Ste 101
Frederick, MD 21703
Phone (301) 694-0870

1144 Opal Ct
Hagerstown, MD 21740
Phone (301) 733-2500

1007 Sushruta Dr
Martinsburg, WV 25401
Phone (304) 263-0991

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1255544748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 SUSHRUTA DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018876",
            "telephone_number": "304-263-0991",
            "fax_number": "304-274-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 SUSHRUTA DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018876",
            "telephone_number": "304-263-0991",
            "fax_number": "304-274-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDHARY",
        "first_name": "NAHLA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "50 054322",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "3881",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "14553",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810015183",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAHLA",
            "last_name": "CHOUDHARY",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.