Active NPI
Pankaj Sanwal, MD
- Pediatrics Physician
- Georgetown, DE
National Provider Identifier
1265528343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C10005413
- Practice address
- 21141 Sterling Ave
Suite 1
Georgetown, DE 19947-5563 - Phone
- (302) 856-3969
- Fax
- (302) 856-3140
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C10005413 | DE | Primary |
Addresses
Primary practice location
21141 Sterling Ave
Suite 1
Georgetown, DE 19947-5563
Mailing address
21141 Sterling Ave
Suite 1
Georgetown, DE 19947-5571
Phone (302) 856-6967
Other practice location 1
1212 Savannah Road
Lewes, DE 19958
Phone (302) 856-6967
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000041255 | Medicaid | DE | |
| 0000904101 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C10005413 | DE | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rainbow Pediatrics | Pediatrics | Past | Accepting new patients |
| Advocare , LLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FJGCAA/Endpoint/FJGCAA
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.
-
- Pediatrics Physician
- Georgetown, DE
- NPI 1306653001
-
- Pediatrics Physician
- Georgetown, DE
- NPI 1013076991
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700179200000",
"number": "1265528343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21141 STERLING AVE",
"address_2": "SUITE 1",
"city": "GEORGETOWN",
"state": "DE",
"postal_code": "199475571",
"telephone_number": "302-856-6967",
"fax_number": "302-855-0744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21141 STERLING AVE",
"address_2": "SUITE 1",
"city": "GEORGETOWN",
"state": "DE",
"postal_code": "199475563",
"telephone_number": "302-856-3969",
"fax_number": "302-856-3140"
}
],
"practiceLocations": [
{
"address_1": "1212 SAVANNAH ROAD",
"address_purpose": "LOCATION",
"city": "LEWES",
"state": "DE",
"postal_code": "19958",
"country_code": "US",
"telephone_number": "302-856-6967",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANWAL",
"first_name": "PANKAJ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2023-11-17",
"certification_date": "2023-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C10005413",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000041255",
"state": "DE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000904101",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Georgetown, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.