Individual provider Active NPI

Toby B Karyadi, CRNP

  • Family Nurse Practitioner
  • Gaithersburg, MD
National Provider Identifier
1013170422
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R177118 Issued in MD
Practice address
18550 Office Park Dr
Gaithersburg, MD 20886-0586
Phone
(301) 330-2700
Fax
(301) 990-7170
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R177118 MD Primary

Addresses

Primary practice location

18550 Office Park Dr
Gaithersburg, MD 20886-0586

Mailing address

PO Box 384
Garrett Park, MD 20896-0384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150408000956 DC Practitioner - Nurse Practitioner 0648598409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Primary Care and Associates LLCGroup PAC ID 5092991984, 167 clinicians
Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians

Practice addresses (Care Compare)

15245 Shady Grove Rd
Suite 150
Rockville, MD 20850-7210
Phone (301) 869-9776

18550 Office Park Dr
Montgomery Village, MD 20886-0586
Phone (301) 869-9776

6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R177118MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: toby.karyadi@cpcl.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1013170422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 384",
            "city": "GARRETT PARK",
            "state": "MD",
            "postal_code": "208960384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18550 OFFICE PARK DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208860586",
            "telephone_number": "301-330-2700",
            "fax_number": "301-990-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARYADI",
        "first_name": "TOBY",
        "middle_name": "B",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R177118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.