Individual provider Active NPI

Sanjeev Kumar Sriram, M.D.

  • Pediatrics Physician
  • Glen Burnie, MD
National Provider Identifier
1891814638
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D69978 Issued in MD
Practice address
200 Hospital Dr Ste 300
Glen Burnie, MD 21061-5884
Phone
(410) 837-2050
Fax
(866) 629-0091
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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 A95935 CA
Pediatrics Physician 208000000X D69978 MD Primary

Addresses

Primary practice location

200 Hospital Dr Ste 300
Glen Burnie, MD 21061-5884

Mailing address

1111 N Charles St
Baltimore, MD 21201-5505
Phone (410) 837-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100901000053 DC Practitioner - Pediatric Medicine 1850498262 Reassigns benefits to 1 organization
I20201228000840 MD Practitioner - Pediatric Medicine 1850498262 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chase Brexton Health Services, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Children's Hospital Current Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Children's Hospital Pediatrics CurrentSince Jun 1, 2010 Accepting new patients
Children's Hospital CurrentSince Jun 1, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
UCLA Pediatrics Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

1111 N Charles St
Baltimore, MD 21201
Phone (410) 486-5991

200 Hospital Dr
Ste 300
Glen Burnie, MD 21061

Organizations & group practices 7

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1891814638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015505",
            "telephone_number": "410-837-2050",
            "fax_number": "866-629-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR STE 300",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615884",
            "telephone_number": "410-837-2050",
            "fax_number": "866-629-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIRAM",
        "first_name": "SANJEEV",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A95935",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D69978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.