NPIMap

Organization Active NPI

Endeavour Healthcare LLC

  • Internal Medicine Physician
  • Havre de Grace, MD
National Provider Identifier
1932043601
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ENDEAVOUR HEALTHCARE LLC
Practice address
415 Market St # a
Havre de Grace, MD 21078-3301
Phone
(443) 275-9164
NPI assigned
Apr 15, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Dev Aditya Gautam BasuNPI 1821386228
Title
Owner
Phone
(413) 794-8490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

415 Market St # a
Havre de Grace, MD 21078-3301

Mailing address

913 Southerly Rd Apt 264
Towson, MD 21204-2629
Phone (443) 275-9164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230410002370 MD Part B Supplier - Clinic/Group Practice 3072988815 Receives reassigned benefits from 9 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, MD; Towson, MD; Rising Sun, MD; Pikesville, MD; Middle River, MD; Havre de Grace, MD; Elkton, MD; Forest Hill, MD…

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Endeavour Healthcare LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1776211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1932043601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 SOUTHERLY RD APT 264",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042629",
            "telephone_number": "443-275-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MARKET ST # A",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783301",
            "telephone_number": "443-275-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVOUR HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "BASU",
        "authorized_official_first_name": "DEV",
        "authorized_official_middle_name": "ADITYA GAUTAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-794-8490"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.