Organization Active NPI

Heart Care of Southern Maryland LLP

  • Cardiovascular Disease Physician
  • Brandywine, MD
National Provider Identifier
1174800304
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
HEART CARE OF SOUTHERN MARYLAND LLP
Practice address
7704 Matapeake Business Dr
Suite 325
Brandywine, MD 20613-3023
Phone
(240) 244-5151
Fax
(240) 244-5131
NPI assigned
Nov 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
Roy Leiboff, M.D.
Title
Partner
Phone
(240) 244-5151

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X

Addresses

Primary practice location

7704 Matapeake Business Dr
Suite 325
Brandywine, MD 20613-3023

Mailing address

7704 Matapeake Business Dr
Suite 325
Brandywine, MD 20613-3023
Phone (240) 244-5151

Other identifiers 1

IdentifierTypeStateIssuer
2288044MedicaidMD

National Provider Directory

National Provider Directory

Locations

2440 M St NW
Ste 314
Washington, DC 20037
Phone (202) 785-4966

7704 Matapeake Business Dr
Ste 325
Brandywine, MD 20613
Phone (240) 244-5151

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1174800304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7704 MATAPEAKE BUSINESS DR",
            "address_2": "SUITE 325",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133023",
            "telephone_number": "240-244-5151",
            "fax_number": "240-244-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7704 MATAPEAKE BUSINESS DR",
            "address_2": "SUITE 325",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133023",
            "telephone_number": "240-244-5151",
            "fax_number": "240-244-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART CARE OF SOUTHERN MARYLAND LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "LEIBOFF",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "240-244-5151",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2288044",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandywine, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.