Individual provider Active NPI

Pankaj Sharma, MD

  • Cardiovascular Disease Physician
  • Dayton, OH
National Provider Identifier
1801837117
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35087111 Issued in OH
Practice address
540 Lincoln Park Blvd
Ste. 200
Dayton, OH 45429-6401
Phone
(937) 298-8058
Fax
(937) 298-5638
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35087111 OH Primary

Addresses

Primary practice location

540 Lincoln Park Blvd
Ste. 200
Dayton, OH 45429-6401

Mailing address

540 Lincoln Park Blvd
Ste. 200
Dayton, OH 45429-6401
Phone (937) 298-8058

Other identifiers 1

IdentifierTypeStateIssuer
2618297MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220419003005 OH Practitioner - Cardiovascular Disease (Cardiology) 9133140304 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35087111OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Jun 6, 2022 Accepting new patients
Premier Health Specialists Inc Cardiovascular Disease CurrentSince Jun 6, 2022 Accepting new patients

Locations

2350 Miami Valley Dr
Ste 310
Dayton, OH 45459
Phone (937) 435-4263

9000 N Main St
Ste 101
Englewood, OH 45415

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 2

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1801837117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 LINCOLN PARK BLVD",
            "address_2": "STE. 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454296401",
            "telephone_number": "937-298-8058",
            "fax_number": "937-298-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LINCOLN PARK BLVD",
            "address_2": "STE. 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454296401",
            "telephone_number": "937-298-8058",
            "fax_number": "937-298-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "PANKAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35087111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2618297",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.