Individual provider Active NPI

Ruchira Thakor, M.D.

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1164455200
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0038041 Issued in MD
Practice address
4 W Rolling Crossroads
Suite 100
Baltimore, MD 21228-6280
Phone
(410) 869-0100
Fax
(410) 601-7317
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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 D0038041 MD Primary

Addresses

Primary practice location

4 W Rolling Crossroads
Suite 100
Baltimore, MD 21228-6280

Mailing address

4 W Rolling XRDS Ste 100
Catonsville, MD 21228-6277
Phone (410) 869-0100

Other identifiers 14

IdentifierTypeStateIssuer
0029OtherCAREFIRST DC
9983OtherKAISER
112467OtherCOVENTRY
281959OtherMAMSI
7134748001OtherCIGNA
200491700MedicaidMD
2330331OtherAETNA HMO
52539002OtherCAREFIRST MARYLAND
7209097OtherAETNA PPO
118890MedicaidMD
011736OtherJOHNS HOPKINS HEALTHCARE
1980256MedicaidMD
1926506OtherUNITED HEALTHCARE
700272OtherNCPPO

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
I20110224000159 MD Practitioner - Family Practice 6901983501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4 W Rolling Crossroads
Suite 100
Catonsville, MD 21228-6280
Phone (410) 869-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0038041MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc CurrentSince Jan 1, 2014 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Jan 1, 2014 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Lifebridge Community Physicians, Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Potomac Physicians PA Family Medicine Past Accepting new patients

Locations

4 W Rolling Cross Rd
Ste 100
Catonsville, MD 21228
Phone (410) 869-0100

4 W Rolling Xrds
Ste 100
Catonsville, MD 21228
Phone (410) 869-0100

9649 Belair Rd
Fl 2
Nottingham, MD 21236
Phone (410) 256-9340

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1164455200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W ROLLING XRDS STE 100",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286277",
            "telephone_number": "410-869-0100",
            "fax_number": "410-601-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W ROLLING CROSSROADS",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212286280",
            "telephone_number": "410-869-0100",
            "fax_number": "410-601-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKOR",
        "first_name": "RUCHIRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0038041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC",
            "identifier": "0029",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "9983",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "112467",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "281959",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7134748001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200491700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2330331",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARYLAND",
            "identifier": "52539002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7209097",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118890",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS HEALTHCARE",
            "identifier": "011736",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980256",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1926506",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "700272",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.