NPIMap

Organization Active NPI

Erickson Health Medical Group of Maryland PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Silver Spring, MD
National Provider Identifier
1205856549
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
ERICKSON HEALTH MEDICAL GROUP OF MARYLAND PC
Practice address
3110 Gracefield Rd
Silver Spring, MD 20904-1820
Phone
(301) 572-8340
Fax
(301) 572-8403
NPI assigned
Jul 20, 2006
Last updated
Nov 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Authorized official

Name
Dr. Matthew J Narrett, M.D.NPI 1144293838
Title
Senior VP and Chief Medical Officer
Phone
(410) 402-2257

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NU
Gerontology Nurse Practitioner 363LG0600X NU
Gerontology Clinical Nurse Specialist 364SG0600X NU
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X NU
Family Medicine Physician 207Q00000X NU
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU
Internal Medicine Physician 207R00000X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary
Podiatrist 213E00000X NU

Addresses

Primary practice location

3110 Gracefield Rd
Silver Spring, MD 20904-1820

Mailing address

5730 Executive Dr Ste 230
Catonsville, MD 21228-1762
Phone (301) 572-8340

Other identifiers 9

IdentifierTypeStateIssuer
138CSEOtherBCBS MD
0008OtherCAREFIRST BCBS
42455801OtherBCBS MD
9680-0059OtherBCBS OF DC
04-04109OtherEVERCARE
0943-SE-881489-01OtherBCBS OF MD
400550300MedicaidMD
T016OtherBCBS DC
008203102MedicaidMD

Other names 1

  • Riderwood Medical Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000610 DC Part B Supplier - Clinic/Group Practice 2860304136 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
Practice locations: Bethesda, MD; Silver Spring, MD

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0976702Ehmg of MD Riderwood Village Medical Ctr3110 Gracefield Road, Silver Spring, MD 20904Provider-performed microscopyApr 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Senior Campus Physician6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1205856549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 EXECUTIVE DR STE 230",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281762",
            "telephone_number": "301-572-8340",
            "fax_number": "301-572-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 GRACEFIELD RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041820",
            "telephone_number": "301-572-8340",
            "fax_number": "301-572-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON HEALTH MEDICAL GROUP OF MARYLAND PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "NARRETT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SENIOR VP AND CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "410-402-2257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "138CSE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "0008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "42455801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF DC",
            "identifier": "9680-0059",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "04-04109",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MD",
            "identifier": "0943-SE-881489-01",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400550300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DC",
            "identifier": "T016",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008203102",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riderwood Medical Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Riderwood Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.