Individual provider Active NPI

Sujatha Kannan, MD

  • Pediatric Critical Care Medicine Physician
  • Baltimore, MD
National Provider Identifier
1871531947
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
D72754 Issued in MD
Practice address
1800 Orleans St
Bloomberg CC 6321
Baltimore, MD 21287-0010
Phone
(410) 955-6412
NPI assigned
Jun 2, 2006
Last updated
May 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2013

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 4301072890 MI
Pediatric Critical Care Medicine Physician 2080P0203X D72754 MD Primary

Addresses

Primary practice location

1800 Orleans St
Bloomberg CC 6321
Baltimore, MD 21287-0010

Mailing address

PO Box 64382
Baltimore, MD 21264-4382

Other identifiers 1

IdentifierTypeStateIssuer
046493700MedicaidMD

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
I20110831000139 MD Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 1052374881 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Aug 4, 2011 Accepting new patients
Johns Hopkins University CurrentSince Aug 4, 2011 Accepting new patients
Johns Hopkins University Current Accepting new patients

Locations

1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037

1800 Orleans St
#6321
Baltimore, MD 21287
Phone (410) 955-6412

600 N Wolfe St
Baltimore, MD 21287

Interoperability endpoints

  • Direct secure messaging: skannan183321@direct.hopkinsmedicine.org

Organizations & group practices 3

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1871531947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64382",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST",
            "address_2": "BLOOMBERG CC 6321",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-955-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNAN",
        "first_name": "SUJATHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301072890",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MD",
            "license": "D72754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046493700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.