Individual provider Active NPI

Pankaj Sanwal, MD

  • Pediatrics Physician
  • Georgetown, DE
National Provider Identifier
1265528343
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C10005413 Issued in DE
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

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1000041255MedicaidDE
0000904101MedicaidDE

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

LicenseStateTypeSpecialty
C10005413DEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rainbow Pediatrics Pediatrics Past Accepting new patients
Advocare , LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.