Individual provider Active NPI

Baljeet S Sethi, M.D.

  • Neurology Physician
  • Waldorf, MD
National Provider Identifier
1316972482
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
D25517 Issued in MD
Practice address
11350 Pembrooke SQ
Suite 312
Waldorf, MD 20603-4809
Phone
(301) 843-0803
Fax
(301) 645-1201
NPI assigned
Jul 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X D25517 MD Primary

Addresses

Primary practice location

11350 Pembrooke SQ
Suite 312
Waldorf, MD 20603-4809

Mailing address

11350 Pembrooke SQ
Suite 312
Waldorf, MD 20603-4809
Phone (301) 843-0803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, GA, TX3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20230206000201 AZ Practitioner - Neurology 7416139662 Reassigns benefits to 1 organization
I20240624003311 GA Practitioner - Neurology 7416139662 Reassigns benefits to 1 organization
I20260107000340 TX Practitioner - Neurology 7416139662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D25517MDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Feb 1, 2023 Accepting new patients
Piedmont Providers LLC CurrentSince Jun 11, 2024 Accepting new patients
Shannon Clinic Family Medicine CurrentSince Nov 1, 2025 Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

340 S Willard St
Cottonwood, AZ 86326
Phone (928) 634-5551

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

1301 Sigman Rd NE
Ste 150
Conyers, GA 30012
Phone (678) 413-6276

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

102 N Magdalen St
San Angelo, TX 76903
Phone (325) 481-2025

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316972482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 PEMBROOKE SQ",
            "address_2": "SUITE 312",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034809",
            "telephone_number": "301-843-0803",
            "fax_number": "301-645-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 PEMBROOKE SQ",
            "address_2": "SUITE 312",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034809",
            "telephone_number": "301-843-0803",
            "fax_number": "301-645-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETHI",
        "first_name": "BALJEET",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "D25517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.