Individual provider Active NPI

Pankaj K Shrivastava, PHARMACIST

  • Pharmacist
  • Glen Burnie, MD
National Provider Identifier
1578163432
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
23793 Issued in MD
Practice address
8B Mountain Rd
Glen Burnie, MD 21060-7974
Phone
(410) 553-4156
Fax
(410) 595-6960
NPI assigned
Oct 29, 2020
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 23793 MD Primary

Addresses

Primary practice location

8B Mountain Rd
Glen Burnie, MD 21060-7974

Mailing address

8B Mountain Rd
Glen Burnie, MD 21060-7974
Phone (410) 553-4156

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

State licenses

LicenseStateTypeSpecialty
23793MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Paas LLC CurrentSince Nov 1, 2020 Accepting new patients
Allswell Assisted Living LLC Current Accepting new patients

Locations

8 Mountain Rd
#B
Glen Burnie, MD 21060
Phone (410) 553-4156

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1578163432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8B MOUNTAIN RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210607974",
            "telephone_number": "410-553-4156",
            "fax_number": "410-595-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8B MOUNTAIN RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210607974",
            "telephone_number": "410-553-4156",
            "fax_number": "410-595-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIVASTAVA",
        "first_name": "PANKAJ",
        "middle_name": "K",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "23793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.