Calvert OBGYN Associates of Southern Maryland, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

CALVERT OBGYN ASSOCIATES OF SOUTHERN MARYLAND, LLC

Practice address

110 Hospital Rd
Suite 211
Prince Frederick, MD 20678-4019

Phone

(410) 535-3642

Fax

(410) 535-6836

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Joseph R Tiralla, MD

Title

Managing Member

Phone

(410) 535-3642

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ruby C Alonzo, M.D.

  • Obstetrics & Gynecology Physician
  • Prince Frederick, MD
  • NPI 1386776193

  Obstetrics & Gynecology

  NPD (past)
• Barbara K Estes, M.D.

  • Obstetrics & Gynecology Physician
  • Prince Frederick, MD
  • NPI 1508998816

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104940139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD",
            "address_2": "SUITE 211",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784019",
            "telephone_number": "410-535-3642",
            "fax_number": "410-535-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD",
            "address_2": "SUITE 211",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784019",
            "telephone_number": "410-535-3642",
            "fax_number": "410-535-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERT OBGYN ASSOCIATES OF SOUTHERN MARYLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIRALLA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "410-535-3642",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE HMO",
            "identifier": "2217716",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MARYLAND",
            "identifier": "KAN9CA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI - SUITE 202",
            "identifier": "366483",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD DC",
            "identifier": "6906-0000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI - SUITE #211",
            "identifier": "367313",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE PPO",
            "identifier": "7394046",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Calvert Internal Medicine Group PA
• Calvert Internal Medicine Group, PA
• Calvert Memorial Hospital of Calvert County
• Calvert Memorial Hospital of Calvert County
• Calvert Memorial Hospital of Calvert County
• Calvert Pathology LLC
• Calvert Physical Therapy and Sports Fitness Center
• Calvert Physical Therapy and Sports Fitness Ctr.
• Calvert Substance Abuse Services
• Calverthealth Medical Center, Inc.

• Obstetrics & Gynecology Physician in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Obstetrics & Gynecology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.