Individual provider Active NPI

Seema Raja Gandhi, MD

  • Internal Medicine Physician
  • Fort Meade, MD
National Provider Identifier
1043495682
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0066961 Issued in MD
Practice address
2479 5TH Street
Fort Meade, MD 20755
Phone
(410) 305-5301
Fax
(410) 305-5345
NPI assigned
Jan 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D006961 MD
Internal Medicine Physician 207R00000X D0066961 MD Primary

Addresses

Primary practice location

2479 5TH Street
Fort Meade, MD 20755

Mailing address

807 Thicket CT
Odenton, MD 21113-4038
Phone (443) 766-0353

Other practice location 1

2480 Llewellyn Ave
Fort George G Meade, MD 20755-5800
Phone (301) 677-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211019000384 MD Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6305016791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D006961MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Hospital Past Accepting new patients

Organizations & group practices 1

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": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1043495682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 THICKET CT",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211134038",
            "telephone_number": "443-766-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2479 5TH STREET",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "20755",
            "telephone_number": "410-305-5301",
            "fax_number": "410-305-5345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2480 Llewellyn Ave",
            "address_purpose": "LOCATION",
            "city": "Fort George G Meade",
            "state": "MD",
            "postal_code": "207555800",
            "country_code": "US",
            "telephone_number": "301-677-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "SEEMA",
        "middle_name": "RAJA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D006961",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0066961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Meade, MD

Sources for this page

Verify at the official NPI Registry.