Individual provider Active NPI

Punam Ghanshyam Thakkar, M.D.

  • Otolaryngology Physician
  • Washington, DC
National Provider Identifier
1619261187
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD045049 Issued in DC
Practice address
2300 M St NW FL 4
Washington, DC 20037-1434
Phone
(202) 741-3250
Fax
(202) 741-3382
NPI assigned
Jun 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD045049 DC Primary

Addresses

Primary practice location

2300 M St NW FL 4
Washington, DC 20037-1434

Mailing address

2300 M St NW FL 4
Washington, DC 20037-1434
Phone (202) 741-3250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DC2 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
I20160707002406 PA Practitioner - Otolaryngology 3577855733 Reassigns benefits to 1 organization
I20170719000529 DC Practitioner - Otolaryngology 3577855733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
State University of New York Downstate Medical Center, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

2300 M St NW
Washington, DC 20037-1434
Phone (202) 677-6990

900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 715-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD045049DCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Faculty Associates, Inc Otolaryngology CurrentSince Jun 9, 2017 Accepting new patients
University of Penn-Medical Group Otolaryngology CurrentSince Jul 1, 2016 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2016 Accepting new patients
University of Penn-Medical Group Current Accepting new patients

Locations

2300 M St NW
Fl 4
Washington, DC 20037
Phone (202) 741-3250

2021 K St NW
Ste 408
Washington, DC 20006
Phone (202) 223-1024

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Interoperability endpoints

  • Direct secure messaging: pthakkar19947@gwmfa.direct-ci.com

Organizations & group practices 4

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 1

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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1619261187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 M ST NW FL 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371434",
            "telephone_number": "202-741-3250",
            "fax_number": "202-741-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 M ST NW FL 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371434",
            "telephone_number": "202-741-3250",
            "fax_number": "202-741-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "PUNAM",
        "middle_name": "GHANSHYAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "DC",
            "license": "MD045049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.