NPIMap

Organization Active NPI

Sanjiv K. Saini M.D.,LLC

  • Specialist
  • Lexington Park, MD
National Provider Identifier
1710020995
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D31545 Issued in MD
Legal business name
SANJIV K. SAINI M.D.,LLC
Practice address
22335 Exploration Dr
Suite 2005
Lexington Park, MD 20653-2014
Phone
(301) 863-7310
Fax
(301) 863-7642
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Dr. Sanjiv K SainiNPI 1598805293
Title
Owner Administrator
Phone
(301) 863-7310

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
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X D31545 MD Primary

Addresses

Primary practice location

22335 Exploration Dr
Suite 2005
Lexington Park, MD 20653-2014

Mailing address

22335 Exploration Dr
Suite 2005
Lexington Park, MD 20653-2014
Phone (301) 863-7310

Other identifiers 5

IdentifierTypeStateIssuer
5546265OtherMDAETNA HEALTHCARE PROVIDER
D31545OtherMDSTATE LICENSE NUMBER
8140 SKOtherMDBLUE CROSS PROVIDER
995802900MedicaidMD
W054 0001OtherDCFEDERAL BLUE CROSS PROVID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050414000755 MD Part B Supplier - Clinic/Group Practice 4082651641 Receives reassigned benefits from 9 practitioners
Practice locations: Edgewater, MD

National Provider Directory

National Provider Directory

Locations

3168 Braverton St
Ste 340
Edgewater, MD 21037
Phone (301) 863-7310

2391 Brandermill Blvd
Ste 201
Gambrills, MD 21054

2391 Brandermill Blvd
Gambrills, MD 21054
Phone (410) 451-9600

22335 Exploration Dr
Lexington Park, MD 20653
Phone (301) 863-5119

22335 Exploration Dr
Ste 2005
Lexington Pk, MD 20653
Phone (301) 863-7310

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1710020995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22335 EXPLORATION DR",
            "address_2": "SUITE 2005",
            "city": "LEXINGTON PARK",
            "state": "MD",
            "postal_code": "206532014",
            "telephone_number": "301-863-7310",
            "fax_number": "301-863-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22335 EXPLORATION DR",
            "address_2": "SUITE 2005",
            "city": "LEXINGTON PARK",
            "state": "MD",
            "postal_code": "206532014",
            "telephone_number": "301-863-7310",
            "fax_number": "301-863-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANJIV K. SAINI M.D.,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "SAINI",
        "authorized_official_first_name": "SANJIV",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "301-863-7310",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D31545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTHCARE PROVIDER",
            "identifier": "5546265",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "D31545",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER",
            "identifier": "8140 SK",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "995802900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUE CROSS PROVID",
            "identifier": "W054 0001",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.