Active NPI
Edomed Medical Associates LLC
- Internal Medicine Physician
- Landover, MD
National Provider Identifier
1154510154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D52900
- Legal business name
- EDOMED MEDICAL ASSOCIATES LLC
- Practice address
- 8700 Central Ave Ste 301
Landover, MD 20785-4853 - Phone
- (301) 324-0078
- NPI assigned
- Oct 16, 2007
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Musa Mark Momoh, MD
- Title
- Owner
- Phone
- (301) 324-0078
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040506000534 | DC | Part B Supplier - Clinic/Group Practice | 6901894211 |
Receives reassigned benefits from 3 practitioners Practice locations: Glenn Dale, MD; Washington, DC |
National Provider Directory
National Provider DirectoryLocations
1328 Southern Ave SE
Ste 217
Washington, DC 20032
Phone (202) 221-8443
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D52900 | MD | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
8700 Central Ave Ste 301
Landover, MD 20785-4853
Mailing address
PO Box 10907
Silver Spring, MD 20914-0907
Phone (301) 324-0078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 27, 2008.
{
"created_epoch": "1192492800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1206576000000",
"number": "1154510154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10907",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209140907",
"telephone_number": "301-324-0078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 CENTRAL AVE STE 301",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207854853",
"telephone_number": "301-324-0078"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDOMED MEDICAL ASSOCIATES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-16",
"last_updated": "2008-03-27",
"status": "A",
"authorized_official_last_name": "MOMOH",
"authorized_official_first_name": "MUSA",
"authorized_official_middle_name": "MARK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "301-324-0078",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "MD",
"license": "D52900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Landover, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.