Individual provider Active NPI

Rohan Hazra, M.D.

  • Pediatric Infectious Diseases Physician
  • Bethesda, MD
National Provider Identifier
1366677239
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
159063 Issued in MA
Practice address
6100 Executive Blvd
Bethesda, MD 20892-0001
Phone
(301) 435-6868
NPI assigned
May 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 159063 MA Primary

Addresses

Primary practice location

6100 Executive Blvd
Bethesda, MD 20892-0001

Mailing address

11912 Reynolds Ave
Potomac, MD 20854-3333
Phone (301) 435-6868

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
159063MAMDPediatric Infectious Diseases Physician

NPI Registry JSON

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1366677239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11912 REYNOLDS AVE",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543333",
            "telephone_number": "301-435-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 EXECUTIVE BLVD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-435-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZRA",
        "first_name": "ROHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-21",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "MA",
            "license": "159063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.