Individual provider Active NPI

Eric R Sundel, M.D.

  • Pediatrics Physician
  • Glen Burnie, MD
National Provider Identifier
1861449340
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0038961 Issued in MD
Practice address
301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone
(410) 787-4565
Fax
(410) 766-7602
NPI assigned
May 28, 2006
Last updated
Nov 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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 D0038961 MD Primary

Addresses

Primary practice location

301 Hospital Dr
Glen Burnie, MD 21061-5803

Mailing address

PO Box 8160
Philadelphia, PA 19101-8160
Phone (800) 355-0808

Other identifiers 1

IdentifierTypeStateIssuer
545901000MedicaidMD

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
I20041013001270 MD Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 7911967963 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0038961MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Maryland-Frederick PC CurrentSince Feb 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Maryland Provo-I Medical Services, PC Past Accepting new patients
Caton Emergency Physicians Past Accepting new patients

Locations

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

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

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1861449340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8160",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191018160",
            "telephone_number": "800-355-0808",
            "fax_number": "610-834-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-787-4565",
            "fax_number": "410-766-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDEL",
        "first_name": "ERIC",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0038961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "545901000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.