Individual provider Active NPI

Upendra Mahat, MD

  • Pediatrics Physician
  • Prince Frederick, MD
National Provider Identifier
1316259732
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0075310 Issued in MD
Practice address
100 Hospital Rd
Prince Frederick, MD 20678-4017
Phone
(410) 414-4629
Fax
(410) 414-4591
NPI assigned
Jul 14, 2010
Last updated
Jun 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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 D0075310 MD Primary

Addresses

Primary practice location

100 Hospital Rd
Prince Frederick, MD 20678-4017

Mailing address

100 Hospital Rd
Prince Frederick, MD 20678-4017
Phone (410) 414-4791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211228001106 DC Practitioner - Pediatric Medicine 5799928719 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0075310MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince Dec 20, 2021 Accepting new patients
Children's Hospital Pediatrics CurrentSince Dec 20, 2021 Accepting new patients
Children's Hospital Current Accepting new patients
Calverthealth Medical Group, LLC Pediatrics Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 884-4177

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1316259732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784017",
            "telephone_number": "410-414-4791",
            "fax_number": "410-414-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784017",
            "telephone_number": "410-414-4629",
            "fax_number": "410-414-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAT",
        "first_name": "UPENDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0075310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.