Individual provider Active NPI

Shruti Suresh Patel, MD

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1760910103
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D90194 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-6749
Fax
(410) 328-7305
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT213563 PA
Pediatrics Physician 208000000X D90194 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

1 Medical Center Blvd
Chester, PA 19013-3902
Phone (610) 447-6680

Other practice location 1

7601 Osler Dr
Towson, MD 21204-7700
Phone (410) 328-6749

Other practice location 2

345 Saint Paul St
Baltimore, MD 21202-2123
Phone (410) 332-9550

Other practice location 3

1 Medical Center Blvd
Crozer Pediatrics, Pob 1, Suite 402
Upland, PA 19013
Phone (610) 619-7410

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
I20230822000009 MD Practitioner - Pediatric Medicine 6305208430 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D90194MDMDPediatrics Physician
MT213563PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince Jul 8, 2023 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics Current Accepting new patients
University of Maryland Pediatric Assoc PA CurrentSince Jul 8, 2023 Accepting new patients
University of Maryland Medical Center, LLC Past Accepting new patients
University of Maryland St. Joseph Medical Center, LLC Past Accepting new patients

Locations

345 Saint Paul St
Baltimore, MD 21202
Phone (410) 332-9594

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

Organizations & group practices 5

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1760910103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-447-6680",
            "fax_number": "610-876-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6749",
            "fax_number": "410-328-7305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7601 Osler Dr",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212047700",
            "country_code": "US",
            "telephone_number": "410-328-6749",
            "fax_number": "410-328-7305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 Saint Paul St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212022123",
            "country_code": "US",
            "telephone_number": "410-332-9550",
            "fax_number": "410-332-5575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "CROZER PEDIATRICS, POB 1, SUITE 402",
            "address_purpose": "LOCATION",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "19013",
            "country_code": "US",
            "telephone_number": "610-619-7410",
            "fax_number": "610-876-8483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHRUTI",
        "middle_name": "SURESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT213563",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D90194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.