Individual provider Active NPI

Corazon Sanchez, MD

  • Pediatrics Physician
  • Port Deposit, MD
National Provider Identifier
1922058650
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0056807 Issued in MD
Practice address
20 Craigtown Rd Ste 101
Port Deposit, MD 21904-1801
Phone
(410) 642-9172
Fax
(410) 642-9176
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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 D0056807 MD Primary

Addresses

Primary practice location

20 Craigtown Rd Ste 101
Port Deposit, MD 21904-1801

Mailing address

20 Craigtown Rd Ste 101
Port Deposit, MD 21904-1801
Phone (410) 642-9172

Other identifiers 1

IdentifierTypeStateIssuer
722001400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0056807MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanchez Counseling, LLC Current Accepting new patients
Corazon-Panes Sanchez,LLC Pediatrics PastSince Nov 24, 2024 Accepting new patients
Corazon-Panes Sanchez,LLC Pediatrics PastSince Nov 1, 2024 Accepting new patients
Corazon-Panes Sanchez,LLC Pediatrics Past Accepting new patients

Locations

4863 Pulaski Hwy
Ste 120
Perryville, MD 21903
Phone (410) 642-9172

Organizations & group practices 4

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1922058650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CRAIGTOWN RD STE 101",
            "city": "PORT DEPOSIT",
            "state": "MD",
            "postal_code": "219041801",
            "telephone_number": "410-642-9172",
            "fax_number": "877-635-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CRAIGTOWN RD STE 101",
            "city": "PORT DEPOSIT",
            "state": "MD",
            "postal_code": "219041801",
            "telephone_number": "410-642-9172",
            "fax_number": "410-642-9176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "CORAZON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0056807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "722001400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Deposit, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.