Individual provider Active NPI

Sunitha Venugopal, MD

  • Pediatrics Physician
  • Abingdon, MD
National Provider Identifier
1720023401
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0057095 Issued in MD
Practice address
39 Kensington Pkwy
Abingdon, MD 21009-1851
Phone
(410) 569-7337
Fax
(410) 569-7347
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0057095 MD Primary

Addresses

Primary practice location

39 Kensington Pkwy
Abingdon, MD 21009-1851

Mailing address

39 Kensington Pkwy
Abingdon, MD 21009-1851
Phone (410) 569-7337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170706000082 MD Practitioner - Pediatric Medicine 6002185121 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0057095MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2017 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients
Box Hill Pediatrics Past Accepting new patients

Locations

12 Medstar Blvd
Ste 265
Bel Air, MD 21015
Phone (301) 540-5246

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1720023401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 KENSINGTON PKWY",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091851",
            "telephone_number": "410-569-7337",
            "fax_number": "410-569-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 KENSINGTON PKWY",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091851",
            "telephone_number": "410-569-7337",
            "fax_number": "410-569-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENUGOPAL",
        "first_name": "SUNITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0057095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, MD

Sources for this page

Verify at the official NPI Registry.