NPIMap

Organization Active NPI

Chesapeake Primary Care Group PA

  • Internal Medicine Physician
  • Pasadena, MD
National Provider Identifier
1609989730
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D31322 Issued in MD
Legal business name
CHESAPEAKE PRIMARY CARE GROUP PA
Practice address
4304 Mountain Rd
Pasadena, MD 21122-4520
Phone
(410) 360-2400
Fax
(410) 439-3342
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Pradeep Garg, M.D.NPI 1952376469
Title
President
Phone
(410) 360-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X D31322 MD Primary

Addresses

Primary practice location

4304 Mountain Rd
Pasadena, MD 21122-4520

Mailing address

14650 Viburnum Dr
Dayton, MD 21036-1246
Phone (410) 360-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101209000972 MD Part B Supplier - Clinic/Group Practice 5890982391 Receives reassigned benefits from 2 practitioners
Practice locations: Pasadena, MD

National Provider Directory

National Provider Directory

Locations

4304 Mountain Rd
Pasadena, MD 21122
Phone (410) 360-2400

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28227/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1609989730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14650 VIBURNUM DR",
            "city": "DAYTON",
            "state": "MD",
            "postal_code": "210361246",
            "telephone_number": "410-360-2400",
            "fax_number": "410-439-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 MOUNTAIN RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224520",
            "telephone_number": "410-360-2400",
            "fax_number": "410-439-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE PRIMARY CARE GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "GARG",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-360-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D31322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.