Individual provider Active NPI

Vijay Soprey, PA

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1336333855
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
D70201 Issued in MD
Practice address
560L Loch Raven Blvd
GSH Pob 406, Dept PM & Rehab
Baltimore, MD 21239
Phone
(410) 532-4701
Fax
(410) 532-4719
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 961845 MD
Medical Physician Assistant 363AM0700X D70201 MD Primary

Addresses

Primary practice location

560L Loch Raven Blvd
GSH Pob 406, Dept PM & Rehab
Baltimore, MD 21239

Mailing address

560L Loch Raven Blvd
GSH Pob 406, Dept PM & Rehab
Baltimore, MD 21239
Phone (410) 532-4701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000175 MD Practitioner - Physician Assistant 4688702889 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
961845MDMDMedical Physician Assistant
D70201MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2015 Accepting new patients
Johns Hopkins University CurrentSince Jul 9, 2018 Accepting new patients
Johns Hopkins University CurrentSince Jul 9, 2018 Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

600 N Wolfe St
Baltimore, MD 21287

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

5501 Hopkins Bayview Cir
Baltimore, MD 21224
Phone (410) 550-0545

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

Organizations & group practices 5

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1336333855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560L LOCH RAVEN BLVD",
            "address_2": "GSH POB 406, DEPT PM & REHAB",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21239",
            "telephone_number": "410-532-4701",
            "fax_number": "410-532-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560L LOCH RAVEN BLVD",
            "address_2": "GSH POB 406, DEPT PM & REHAB",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21239",
            "telephone_number": "410-532-4701",
            "fax_number": "410-532-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOPREY",
        "first_name": "VIJAY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "961845",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "D70201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.