NPIMap

Organization Active NPI

Mobile Medical Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Germantown, MD
National Provider Identifier
1093197345
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MOBILE MEDICAL CARE, INC.
Practice address
19735 Germantown Rd
Suite 300
Germantown, MD 20874-1214
Phone
(301) 493-2400
NPI assigned
Jun 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Yuhanis Saleh
Title
Director of Finance & Admin
Phone
(301) 841-0833

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

19735 Germantown Rd
Suite 300
Germantown, MD 20874-1214

Mailing address

12320 Parklawn Dr
Rockville, MD 20852-1726
Phone (301) 841-0833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151030001695 MD Part A Provider - Federally Qualified Health Center (FQHC) 5597075754 Practice locations: Germantown, MD

Federally qualified health center certification: CCN 211902

Legal name
MOBILE MEDICAL CARE, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 14, 2015
Last certification
Sep 14, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
19735 Germantown Rd
Ste 300
Germantown, MD 20874-1223

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2057331Mobile Medical Care, Inc19735 Germantown Road, Germantown, MD 20874Certificate of waiverApr 14, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

19735 Germantown Rd
Ste 300
Germantown, MD 20874
Phone (301) 634-9600

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mobile Medical Care, Inc. Organization, Rockville, MD Corporation, Non-profit Operational/Managerial Control Oct 1, 2024
Charlotte Jenkins Individual W-2 Managing EmployeeExecutive Director Oct 1, 2024

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mobile Medical Care, Inc.Gaithersburg, MD, CCN 801016 Federally qualified health center Operational/Managerial Control Oct 1, 2024
Mobile Medical Care, Inc.Aspen Hill, MD, CCN 801018 Federally qualified health center Operational/Managerial Control Oct 1, 2024
Mobile Medical Care, Inc.Rockville, MD, CCN 801023 Federally qualified health center Operational/Managerial Control Oct 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1093197345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12320 PARKLAWN DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208521726",
            "telephone_number": "301-841-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19735 GERMANTOWN RD",
            "address_2": "SUITE 300",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741214",
            "telephone_number": "301-493-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "SALEH",
        "authorized_official_first_name": "YUHANIS",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE & ADMIN",
        "authorized_official_telephone_number": "301-841-0833"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.