Individual provider Active NPI

Pavandip Virdi, MD

  • Family Medicine Physician
  • Dover, DE
National Provider Identifier
1376063735
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C1-0024124 Issued in DE
Practice address
1074 S State St
Dover, DE 19901-6925
Phone
(302) 725-3214
Fax
(302) 725-3215
NPI assigned
Jun 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT214501 PA
Family Medicine Physician 207Q00000X C1-0024124 DE Primary

Addresses

Primary practice location

1074 S State St
Dover, DE 19901-6925

Mailing address

640 S. State Street, Mail Code 3055
Dover, DE 19901-3530
Phone (302) 480-1688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20210706000045 DE Practitioner - HospitalistPractitioner - Family Practice 6002238193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

1074 S State St
Bayhealth Family Medicine Dover
Dover, DE 19901-6925
Phone (302) 735-3214

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT214501PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Jun 1, 2021 Accepting new patients
Bayhealth Medical Center, Inc. Current Accepting new patients
Apogee Medical Group, Delaware, Inc CurrentSince Dec 1, 2021 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Jun 1, 2021 Accepting new patients
Bayhealth Medical Center, Inc Family Medicine Past Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients

Locations

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

640 S State St
Dover, DE 19901
Phone (302) 744-4700

1074 S State St
Dover, DE 19901
Phone (302) 678-8100

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1376063735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET, MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199016925",
            "telephone_number": "302-725-3214",
            "fax_number": "302-725-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRDI",
        "first_name": "PAVANDIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2021-05-14",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT214501",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0024124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.