Organization Active NPI

Capital Colon & Rectal Clinic, PA

  • Colon & Rectal Surgery Physician
  • Bel Air, MD
National Provider Identifier
1164169926
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
CAPITAL COLON & RECTAL CLINIC, PA
Practice address
602 S Atwood Rd Ste 205
Bel Air, MD 21014-4329
Phone
(410) 803-2211
Fax
(410) 420-9841
NPI assigned
May 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Authorized official

Name
Dr. Preetha Ali, MDNPI 1346404902
Title
Colon & Rectal Surgeon
Phone
(301) 325-3377

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
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X Primary

Addresses

Primary practice location

602 S Atwood Rd Ste 205
Bel Air, MD 21014-4329

Mailing address

22626 Tate St
Clarksburg, MD 20871-6393
Phone (301) 325-3377

Other identifiers 1

IdentifierTypeStateIssuer
12716723OtherCAQH

National Provider Directory

National Provider Directory

Locations

602 S Atwood Rd
Ste 205
Bel Air, MD 21014
Phone (410) 588-5681

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1164169926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22626 TATE ST",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208716393",
            "telephone_number": "301-325-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 S ATWOOD RD STE 205",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144329",
            "telephone_number": "410-803-2211",
            "fax_number": "410-420-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL COLON & RECTAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "PREETHA",
        "authorized_official_title_or_position": "COLON & RECTAL SURGEON",
        "authorized_official_telephone_number": "301-325-3377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12716723",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.