Individual provider Active NPI

Indrayani Mukund Karkhanis, MD

  • Family Medicine Physician
  • Ellicott City, MD
National Provider Identifier
1164413852
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D66733 Issued in MD
Practice address
4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766
Phone
(410) 997-5191
Fax
(410) 997-7957
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D66733 MD Primary

Addresses

Primary practice location

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766

Mailing address

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766
Phone (410) 997-5191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080313000301 MD Practitioner - Family Practice 2365472388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Medical Associates LLCGroup PAC ID 0446470165, 18 clinicians

Practice addresses (Care Compare)

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7749
Phone (443) 393-3788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Medical Associates, LLC CurrentSince Aug 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Potomac Physician Associates Family Medicine Past Accepting new patients

Locations

4801 Dorsey Hall Dr
#G
Ellicott City, MD 21042
Phone (443) 393-3788

4801 Dorsey Hall Dr
Ste 201
Ellicott City, MD 21042
Phone (410) 997-5191

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1164413852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 201",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-997-5191",
            "fax_number": "410-997-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 201",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-997-5191",
            "fax_number": "410-997-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARKHANIS",
        "first_name": "INDRAYANI",
        "middle_name": "MUKUND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D66733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.