Individual provider Active NPI

Madan S Bangalore, M.D.

  • Internal Medicine Physician
  • Germantown, MD
National Provider Identifier
1174798193
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0067512 Issued in MD
Practice address
20410 Observation Dr 210
Germantown, MD 20876-6422
Phone
(301) 869-9776
Fax
(301) 417-4947
NPI assigned
Apr 30, 2008
Last updated
Oct 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0067512 MD Primary

Addresses

Primary practice location

20410 Observation Dr 210
Germantown, MD 20876-6422

Mailing address

15825 Shady Grove Rd
Suite 140
Rockville, MD 20850-4008
Phone (301) 869-9776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20081001000075 DC Practitioner - Internal Medicine 5698843894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Primary Care and Associates LLCGroup PAC ID 5092991984, 167 clinicians
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians

Practice addresses (Care Compare)

15245 Shady Grove Rd
Suite 150
Rockville, MD 20850-7210
Phone (301) 869-9776

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

20410 Observation Dr
Suite 210
Germantown, MD 20876-6422
Phone (301) 869-9776

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0067512MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Inpatient Specialists PA Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: madan.bangalore@cpcl.eclinicaldirectplus.com
  • Direct secure messaging: madan.bangaloremd.p2@direct.msmg.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1174798193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15825 SHADY GROVE RD",
            "address_2": "SUITE 140",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504008",
            "telephone_number": "301-869-9776",
            "fax_number": "301-216-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20410 OBSERVATION DR 210",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208766422",
            "telephone_number": "301-869-9776",
            "fax_number": "301-417-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGALORE",
        "first_name": "MADAN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0067512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.