Individual provider Active NPI

Sanju Gurung Pandey

  • Acute Care Nurse Practitioner
  • Washington, DC
National Provider Identifier
1801564315
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP1041205 Issued in DC
Practice address
110 Irving St NW
Washington, DC 20010-3017
Phone
(202) 877-7000
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN1041205 DC
Acute Care Nurse Practitioner 363LA2100X NP1041205 DC Primary

Addresses

Primary practice location

110 Irving St NW
Washington, DC 20010-3017

Mailing address

22810 Glacier Lily Dr
Clarksburg, MD 20871-6331
Phone (570) 862-4981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220216002034 DC Practitioner - Nurse Practitioner 3577956481 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1041205DCMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Hospital Center Corp Current Accepting new patients
Washington Hospital Center Corp CurrentSince Nov 10, 2021 Accepting new patients
Medstar Heart Institute LLC CurrentSince Mar 1, 2023 Accepting new patients
Washington Hospital Center Corp CurrentSince Nov 10, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

110 Irving St NW
Ste 5A
Washington, DC 20010

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

2000 15th St N
Ste 600
Arlington, VA 22201
Phone (202) 425-0000

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1801564315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22810 GLACIER LILY DR",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208716331",
            "telephone_number": "570-862-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103017",
            "telephone_number": "202-877-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURUNG PANDEY",
        "first_name": "SANJU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "DC",
            "license": "RN1041205",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "DC",
            "license": "NP1041205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.