Individual provider Active NPI

Rithu Moideenkutty, SLP

  • Speech-Language Pathologist
  • Silver Spring, MD
National Provider Identifier
1104340876
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
08364 Issued in MD
Practice address
3701 International Dr
Silver Spring, MD 20906-1556
Phone
(301) 598-2900
NPI assigned
Aug 3, 2017
Last updated
Aug 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 08364 MD Primary

Addresses

Primary practice location

3701 International Dr
Silver Spring, MD 20906-1556

Mailing address

101 Paddock Dr
Fruitland, MD 21826-2101
Phone (443) 397-5595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200508000486 DC Practitioner - Qualified Speech Language Pathologist 7719318682 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians
Jewish Foundation for Group HomesGroup PAC ID 2264879758, 4 clinicians

Practice addresses (Care Compare)

12052 N Shore Dr
Reston, VA 20190-4969
Phone (888) 531-2204

6101 Executive Blvd
Suite 280
Rockville, MD 20852-3910
Phone (240) 283-6000

9701 Veirs Dr
Rockville, MD 20850-3414
Phone (888) 531-2204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08634MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Foundation for Group Homes Speech-Language Pathologist CurrentSince Mar 6, 2024 Accepting new patients

Locations

1500 E Jefferson St
Rockville, MD 20852
Phone (240) 283-6000

6101 Executive Blvd
Ste 280
Rockville, MD 20852
Phone (240) 283-6000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501718400000",
    "number": "1104340876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PADDOCK DR",
            "city": "FRUITLAND",
            "state": "MD",
            "postal_code": "218262101",
            "telephone_number": "443-397-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 INTERNATIONAL DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061556",
            "telephone_number": "301-598-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOIDEENKUTTY",
        "first_name": "RITHU",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "08364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.