Individual provider Active NPI

Suhair A Abulfarag, MD

  • Internal Medicine Physician
  • Gaithersburg, MD
National Provider Identifier
1093818932
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D31392 Issued in MD
Practice address
604 S Frederick Ave Ste 413
Gaithersburg, MD 20877-1284
Phone
(301) 330-4414
Fax
(301) 216-1637
NPI assigned
Sep 6, 2006
Last updated
May 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D31392 MD Primary

Addresses

Primary practice location

604 S Frederick Ave Ste 413
Gaithersburg, MD 20877-1284

Mailing address

604 S Frederick Ave Ste 413
Gaithersburg, MD 20877-1284
Phone (301) 330-4414

Other identifiers 2

IdentifierTypeStateIssuer
40141802OtherMDBCBS
211791600MedicaidMD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071217000753 DC Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6608966403 Practice locations: Gaithersburg, MD

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

604 S Frederick Ave
Gaithersburg, MD 20877-1284
Phone (301) 330-4414

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D31392MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1093818932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S FREDERICK AVE STE 413",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771284",
            "telephone_number": "301-330-4414",
            "fax_number": "301-216-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S FREDERICK AVE STE 413",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771284",
            "telephone_number": "301-330-4414",
            "fax_number": "301-216-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABULFARAG",
        "first_name": "SUHAIR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D31392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "40141802",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211791600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.