Vivek Nag (NPI# 1205817459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1205817459 |
| Entity Type | Individual |
| Full Name | Vivek Nag |
| Credential | MD |
| Gender | Male |
| Practice Address |
3510 Old Washington Road Suite 100 Waldorf MD 20602-3234 |
| Practice Telephone | 3019325890 |
| Practice Fax Number | 3016456361 |
| Mailing Address |
3510 Old Washington Road Suite 100 Waldorf MD 20602-3234 |
| Mailing Telephone | 3019325890 |
| Mailing Fax Number | 3016456361 |
| Sole Proprietor | No, this individual is not a Sole Proprietor |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2012-10-08 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 207RC0000X | Internal Medicine · Cardiovascular Disease | Allopathic & Osteopathic Physicians | D0043070 | MD |
| No | 207RC0000X | Internal Medicine · Cardiovascular Disease | Allopathic & Osteopathic Physicians | MD30816 | DC |
| State | Identifier | Issuer | Type Code |
|---|---|---|---|
| MD | 138871100 | MEDICAID |
| NPI | 1205817459 |
| PAC ID by PECOS | 2264412972 |
| Professional Enrollment ID | I20100715000486 |
| Full Name | Vivek Nag |
| Organization Legal Name | HEART CENTER OF SOUTHERN MARYLAND LLP |
| Phone Number | 3019325890 |
| Gender | M |
| Credential | MD |
| Medical School | EASTERN VIRGINIA MEDICAL SCHOOL |
| Graduation Year | 1993 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 5193710325 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Report Quality Measures | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210035 | UNIVERSITY OF MD CHARLES REGIONAL MEDICAL CENTER |
| 210062 | MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER |
| Street Address |
3510 OLD WASHINGTON ROAD SUITE 100 |
| City | WALDORF |
| State | MD |
| Zip Code | 20602-3234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770572042 | Henriot St Gerard | Specialist | 3510 Old Washington Road, Second Floor, Waldorf, MD 20603 | 2005-10-19 |
| 1295861235 | Susan Caroline Herron | Nurse Practitioner | 3510 Old Washington Road, Suite 100, Waldorf, MD 20602 | 2007-02-26 |
| 1720191455 | Carolyn B Martin | Registered Nurse | 3510 Old Washington Road, 2nd Floor, Waldorf, MD 20602 | 2006-08-16 |
| 1740261924 | Gopalakrishnan Srinivasan | Internal Medicine | 3510 Old Washington Road, Suite 100, Waldorf, MD 20602-3234 | 2005-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396227039 | Lantern Family Services Inc | Community/Behavioral Health | 11680 Doolittle Dr Ste 111, Waldorf, MD 20602 | 2018-08-29 |
| 1093294910 | Metropolitan Vascular Institute LLC | Internal Medicine | 12070 Old Line Ctr Ste 100, Waldorf, MD 20602 | 2018-08-10 |
| 1174009922 | Dr. Arthur B. Sorkin, D.d.s., LLC | Dentist | 3460 Old Washington Rd., Suite 301-b, Waldorf, MD 20602 | 2018-07-16 |
| 1467945030 | Donna Marie Conley-shaw | Behavior Technician | 16 Pagnell Cir, Waldorf, MD 20602 | 2018-06-08 |
| 1811404296 | Loni Berbaum | Speech-Language Pathologist | 4817 Elmley Pl Apt 315, Waldorf, MD 20602 | 2018-01-06 |
| 1891224853 | Linda E Smith | Social Worker | 605 Pst Office Road, #301, Waldorf, MD 20602 | 2017-06-05 |
| 1104373273 | Love Ngum Che | Pharmacist | 25 Smallwood Village, Waldorf, MD 20602 | 2016-09-07 |
| 1639543341 | Matengy Toure | Pharmacist | 129 St Charles Pkwy, Waldorf, MD 20602 | 2015-11-18 |
| 1154708204 | Erin Latrice Palmer | Registered Nurse | 605 Post Office Rd Ste 102, Waldorf, MD 20602 | 2015-04-28 |
| 1225459936 | Pain and Wellness Center of Maryland, LLC | Physical Medicine & Rehabilitation | 601 Post Office Rd Ste 2a, Waldorf, MD 20602 | 2013-12-23 |
| Find all providers in zip 20602 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760587596 | Samuel B Itscoitz | Internal Medicine | 12070 Old Line Ctr Ste 303, Waldorf, MD 20602-3535 | 2006-09-14 |
| 1386812113 | Elizabeth Hurt | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2008-02-14 |
| 1265553960 | Jerry Salan | Internal Medicine | 13464 Holly Spring Dr, Waldorf, MD 20601-2329 | 2007-04-02 |
| 1669585113 | Chesapeake&washington Heart Care, PC | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2006-08-17 |
| 1790702157 | Jeffrey B Trabb | Internal Medicine | 2670 Crain Hwy, Suite 300, Waldorf, MD 20601-2806 | 2006-07-15 |
| 1699714469 | Maryland Healthcare Associates LLC | Internal Medicine | 12070 Old Line Ctr, Suite 100, Waldorf, MD 20602-2513 | 2006-06-06 |
| 1669438933 | Terrance A. Collins | Internal Medicine | 2670 Crain Hwy, Suite 300, Waldorf, MD 20601-2806 | 2006-04-25 |
| 1699746271 | Thomas B Haywood | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2006-01-31 |
| 1356322598 | Satish Jumani | Internal Medicine | 12070 Old Line Ctr, Suite 202, Waldorf, MD 20602-2513 | 2005-11-07 |
| 1740261924 | Gopalakrishnan Srinivasan | Internal Medicine | 3510 Old Washington Road, Suite 100, Waldorf, MD 20602-3234 | 2005-11-07 |
| Find all providers in WALDORF | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.