NPIMap

Individual provider Active NPI

Anitha Nallu, MD

  • Nephrology Physician
  • Frederick, MD
National Provider Identifier
1164530275
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D0067325 Issued in MD
Practice address
5205 Chairmans CT Ste 100
Frederick, MD 21703-2916
Phone
(301) 696-0012
Fax
(301) 696-0016
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101240273 VA
Internal Medicine Physician 207R00000X MD036252 DC
Nephrology Physician 207RN0300X D0067325 MD Primary

Addresses

Primary practice location

5205 Chairmans CT Ste 100
Frederick, MD 21703-2916

Mailing address

5205 Chairmans CT Ste 100
Frederick, MD 21703-2916
Phone (301) 696-0012

Other practice location 1

106 Irving St NW POB South
Suite 309
Washington, DC 20010
Phone (202) 291-3122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102001229 MD Practitioner - NephrologyPractitioner - Internal Medicine 7012019219 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Nephrology Associates PAGroup PAC ID 2769469006, 60 clinicians

Practice addresses (Care Compare)

25 Crossroads Dr
Suite 205
Owings Mills, MD 21117-5533
Phone (410) 602-7792

Hospital & facility affiliations

  • DaVita Owings Mills Dialysis Center Dialysis facility, Owings Mills, MD, CCN 212574
  • DaVita Kidney Home Center PD Dialysis facility, Windsor Mill, MD, CCN 212659
  • DaVita Northwest Dialysis Center Dialysis facility, Windsor Mill, MD, CCN 212655
  • Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040
  • University of MD St Joseph Medical Center Hospital, Towson, MD, CCN 210063
  • Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD036252DCMDInternal Medicine Physician
0101240273VAMDInternal Medicine Physician
D0067325MDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shore-Bayy Hospitalists Associates CurrentSince Oct 28, 2017 Accepting new patients
Northwest Hospital Center, Inc. CurrentSince Mar 1, 2018 Accepting new patients
Northwest Hospital Center, Inc Internal Medicine CurrentSince Mar 1, 2018 Accepting new patients
Mid-Atlantic Nephrology Associates PA Nephrology CurrentSince May 3, 2021 Accepting new patients
Primary Care Doctors Group,PC Internal Medicine Past Accepting new patients
Shore Hospitalists Associates P.a. Internal Medicine PastSince Oct 28, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5999 Harpers Farm Rd
Ste W250
Columbia, MD 21044
Phone (410) 772-8822

1589 Sulphur Spring Rd
Ste 109
Halethorpe, MD 21227
Phone (410) 536-5400

25 Crossroads Dr
Ste 205
Owings Mills, MD 21117
Phone (410) 602-7792

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Interoperability endpoints

  • Direct secure messaging: anithanallu@mana.allscriptsdirect.net
  • Direct secure messaging: anallu61279@direct.umm.edu

Organizations & group practices 7

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 6

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164530275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 CHAIRMANS CT STE 100",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217032916",
            "telephone_number": "301-696-0012",
            "fax_number": "301-696-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 CHAIRMANS CT STE 100",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217032916",
            "telephone_number": "301-696-0012",
            "fax_number": "301-696-0016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Irving St NW POB South",
            "address_2": "Suite 309",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20010",
            "country_code": "US",
            "telephone_number": "202-291-3122",
            "fax_number": "202-291-0655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NALLU",
        "first_name": "ANITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101240273",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD036252",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0067325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.