Individual provider Active NPI

Kanwal Razzaq, M.D.

  • Hospitalist Physician
  • Bluefield, WV
National Provider Identifier
1407003262
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
25388 Issued in WV
Practice address
510 Cherry St
BLDG a, Ste 104a
Bluefield, WV 24701-3338
Phone
(304) 325-1992
Fax
(304) 327-1839
NPI assigned
Aug 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25388 WV
Infectious Disease Physician 207RI0200X 25388 WV
Hospitalist Physician 208M00000X 25388 WV Primary

Addresses

Primary practice location

510 Cherry St
BLDG a, Ste 104a
Bluefield, WV 24701-3338

Mailing address

510 Cherry St
BLDG a, Ste 104a
Bluefield, WV 24701-3338
Phone (304) 325-1992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, MD2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20131106001745 WV Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Infectious Disease 7012142664
I20170307000503 MD Practitioner - Internal MedicinePractitioner - Infectious Disease 7012142664 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians
St Agnes Healthcare IncGroup PAC ID 9830092733, 265 clinicians

Practice addresses (Care Compare)

2435 W Belvedere Ave
56 Sinai General Medicine Associates
Baltimore, MD 21215-5224
Phone (410) 601-6840

900 Caton Ave
Baltimore, MD 21229-5201
Phone (667) 234-3120

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012
  • Saint Agnes Hospital Hospital, Baltimore, MD, CCN 210011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25388WVMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Agnes Healthcare Inc CurrentSince Sep 16, 2019 Accepting new patients
Sinai Hospital of Baltimore Inc Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Mdics at Anne Arundel LLC Hospitalist CurrentSince Mar 1, 2017 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
St Agnes Healthcare Inc Internal Medicine CurrentSince Sep 16, 2019 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jul 1, 2017 Accepting new patients
St. Agnes Healthcare, Inc. Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Bluefield HBP Medical Group LLC Past Accepting new patients

Locations

904 Commerce Rd
Annapolis, MD 21401
Phone (410) 849-6140

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Interoperability endpoints

  • Direct secure messaging: razzaqk@yourcarecommunity.org

Organizations & group practices 9

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 3

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": "1219536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1407003262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 CHERRY ST",
            "address_2": "BLDG A, STE 104A",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013338",
            "telephone_number": "304-325-1992",
            "fax_number": "304-327-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CHERRY ST",
            "address_2": "BLDG A, STE 104A",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013338",
            "telephone_number": "304-325-1992",
            "fax_number": "304-327-1839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZZAQ",
        "first_name": "KANWAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-24",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "25388",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WV",
            "license": "25388",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WV",
            "license": "25388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, WV

Sources for this page

Verify at the official NPI Registry.