Individual provider Active NPI

Ganesh Tamang, NP

  • Nurse Practitioner
  • Essex, MD
National Provider Identifier
1225748197
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R242002 Issued in MD
Practice address
1124 Mace Ave
Essex, MD 21221-3315
Phone
(410) 391-6996
NPI assigned
Dec 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R242002 MD Primary

Addresses

Primary practice location

1124 Mace Ave
Essex, MD 21221-3315

Mailing address

8640 Jessica LN
Perry Hall, MD 21128-9671
Phone (443) 682-5444

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230403002894 MD Practitioner - Nurse Practitioner 8224403365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mace Medical LLCGroup PAC ID 8123308020, 15 clinicians

Practice addresses (Care Compare)

1124 Mace Ave
Baltimore, MD 21221-3315
Phone (410) 391-6996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R242002MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sciometrix Inc CurrentSince Jul 15, 2024 Accepting new patients
Mace Medical LLC CurrentSince Mar 1, 2023 Accepting new patients
Sciometrix LLC PastSince Oct 10, 2021 Accepting new patients

Locations

2800 Sollers Point Rd
Dundalk, MD 21222
Phone (410) 391-6996

1124 Mace Ave
Essex, MD 21221
Phone (410) 391-6996

15005 Shady Grove Rd
Ste 240
Rockville, MD 20850
Phone (301) 217-0979

306 S Washington Ave
Ste 600
Royal Oak, MI 48067

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JHCFBA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1225748197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 JESSICA LN",
            "city": "PERRY HALL",
            "state": "MD",
            "postal_code": "211289671",
            "telephone_number": "443-682-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 MACE AVE",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212213315",
            "telephone_number": "410-391-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMANG",
        "first_name": "GANESH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R242002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, MD

Sources for this page

Verify at the official NPI Registry.