Individual provider Active NPI

Pavan Nath Segal, M.D.

  • Child & Adolescent Psychiatry Physician
  • Rockville, MD
National Provider Identifier
1437390804
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
D78379 Issued in MD
Practice address
14901 Broschart Rd
Rockville, MD 20850-3318
Phone
(301) 251-4582
NPI assigned
Mar 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A106928 CA
Child & Adolescent Psychiatry Physician 2084P0804X 036124940 IL
Child & Adolescent Psychiatry Physician 2084P0804X D78379 MD Primary

Addresses

Primary practice location

14901 Broschart Rd
Rockville, MD 20850-3318

Mailing address

14901 Broschart Rd
Rockville, MD 20850-3318
Phone (301) 251-4582

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A106928CAMDPsychiatry Physician
D78379MDMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1437390804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14901 BROSCHART RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503318",
            "telephone_number": "301-251-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 BROSCHART RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503318",
            "telephone_number": "301-251-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "PAVAN",
        "middle_name": "NATH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-16",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A106928",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036124940",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D78379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.