Roza Medical Center, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

ROZA MEDICAL CENTER, LLC

Practice address

941 Russell Ave Ste B
Gaithersburg, MD 20879-6206

Phone

(240) 848-7692

NPI assigned

Jul 3, 2023

Last updated

Mar 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bulat Khamitov

Title

Ceo

Phone

(240) 848-7692

Specialties & licenses 2

Addresses

Other names 1

• Roza Medical Center, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roza Liss, CRNP

  • Primary Care Nurse Practitioner
  • Gaithersburg, MD
  • NPI 1235362781

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742601600000",
    "number": "1023795945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 RUSSELL AVE STE B",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208796206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 RUSSELL AVE STE B",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208796206",
            "telephone_number": "240-848-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROZA MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-03",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A",
        "authorized_official_last_name": "KHAMITOV",
        "authorized_official_first_name": "BULAT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-848-7692"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roza Medical Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Roza Medical Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Sofia Rubenstein, LGSW
• Adam Paul Rubin, O.D.
• Leonard Rubinstein, D.D.S.
• Airelle Rucker-Smith, DNP, CRNP
• Joan Rudick, LCSW-C

• Nurse Practitioner in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.