Organization Active NPI

Patuxent Rheumatology Associates,LLC

  • Rheumatology Physician
  • Prince Frederick, MD
National Provider Identifier
1063692291
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
D0059442 Issued in MD
Legal business name
PATUXENT RHEUMATOLOGY ASSOCIATES,LLC
Practice address
995 N. Prince Frederick Blvd
Suite 103
Prince Frederick, MD 20678-3151
Phone
(410) 414-3437
Fax
(410) 414-3451
NPI assigned
Nov 5, 2007
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Dr. Asha George, MDNPI 1952311482
Title
Medical Director
Phone
(410) 414-3437

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
Rheumatology Physician 207RR0500X D0059442 MD Primary

Addresses

Primary practice location

995 N. Prince Frederick Blvd
Suite 103
Prince Frederick, MD 20678-3151

Mailing address

PO Box 424
Prince Frederick, MD 20678-0424
Phone (410) 414-3437

Other identifiers 5

IdentifierTypeStateIssuer
7253531OtherMDAETNA
395A-PAOtherMDCAREFIRST
J527OtherMDBLUE CHOICE AND FED
2121894OtherMDFELRA & GEHA
408633300MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050202000260 MD Part B Supplier - Clinic/Group Practice 1355392861 Receives reassigned benefits from 1 practitioner
Practice locations: Prince Frederick, MD

National Provider Directory

National Provider Directory

Locations

995 Prince Frederick Blvd
Ste 103
Prnc Frederck, MD 20678
Phone (410) 414-3437

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1063692291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206780424",
            "telephone_number": "410-414-3437",
            "fax_number": "410-414-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 N. PRINCE FREDERICK BLVD",
            "address_2": "SUITE 103",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783151",
            "telephone_number": "410-414-3437",
            "fax_number": "410-414-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATUXENT RHEUMATOLOGY ASSOCIATES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "ASHA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-414-3437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MD",
            "license": "D0059442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7253531",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "395A-PA",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE  AND FED",
            "identifier": "J527",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FELRA & GEHA",
            "identifier": "2121894",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408633300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.