NPIMap

Individual provider Active NPI

Suresh M Dhanjani, M.D.

  • Internal Medicine Physician
  • Havre de Grace, MD
National Provider Identifier
1720083314
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D45344 Issued in MD
Practice address
622 S Union Ave
Havre de Grace, MD 21078-3422
Phone
(410) 939-3770
NPI assigned
Jun 20, 2005
Last updated
Jan 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D45344 MD Primary

Addresses

Primary practice location

622 S Union Ave
Havre de Grace, MD 21078-3422

Mailing address

615 W Macphail Rd
Ste 106
Bel Air, MD 21014-4393
Phone (410) 638-8900

Other identifiers 1

IdentifierTypeStateIssuer
128391000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000134 MD Practitioner - Internal Medicine 1153217898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Harford Primary Care LLCGroup PAC ID 3971499971, 27 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

2 N Ave
Suite 101
Bel Air, MD 21014-2303
Phone (410) 838-6434

622 S Union Ave
Havre de Grace, MD 21078-3422
Phone (410) 939-3770

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harford Primary Care LLC CurrentSince Jul 1, 1999 Accepting new patients
Harford Primary Care LLC PastSince Mar 24, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2 North Ave
Ste 101
Bel Air, MD 21014
Phone (410) 296-1661

615 W Macphail Rd
Ste 106
Bel Air, MD 21014
Phone (410) 638-8900

622 S Union Ave
Hvre de Grace, MD 21078
Phone (410) 939-3770

Interoperability endpoints

  • Direct secure messaging: sdhanjani651584@direct.umm.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1720083314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W MACPHAIL RD",
            "address_2": "STE 106",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144393",
            "telephone_number": "410-638-8900",
            "fax_number": "410-638-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 S UNION AVE",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783422",
            "telephone_number": "410-939-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANJANI",
        "first_name": "SURESH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D45344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128391000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

Verify at the official NPI Registry.