Organization Active NPI

Professional Physician Services LLC

  • Internal Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1114935939
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROFESSIONAL PHYSICIAN SERVICES LLC
Practice address
7845 Oakwood Rd
Suite 100
Glen Burnie, MD 21061-4280
Phone
(410) 760-1010
Fax
(410) 787-1056
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jude Cabatingan Muneses, M.D.NPI 1548286289
Title
President
Phone
(410) 760-1010

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD Primary

Addresses

Primary practice location

7845 Oakwood Rd
Suite 100
Glen Burnie, MD 21061-4280

Mailing address

7845 Oakwood Rd
Suite 100
Glen Burnie, MD 21061-4280
Phone (410) 760-1010

Other identifiers 1

IdentifierTypeStateIssuer
LZ85PROtherMDBLUE SHIELD OF MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114935939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7845 OAKWOOD RD",
            "address_2": "SUITE 100",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614280",
            "telephone_number": "410-760-1010",
            "fax_number": "410-787-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7845 OAKWOOD RD",
            "address_2": "SUITE 100",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614280",
            "telephone_number": "410-760-1010",
            "fax_number": "410-787-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUNESES",
        "authorized_official_first_name": "JUDE",
        "authorized_official_middle_name": "CABATINGAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-760-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MD",
            "identifier": "LZ85PR",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • 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.