Organization Active NPI

Menon Medical Center LLC

  • Internal Medicine Physician
  • Kensington, MD
National Provider Identifier
1245636455
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0057879 Issued in MD
Legal business name
MENON MEDICAL CENTER LLC
Practice address
10605 Concord St
Suite 300
Kensington, MD 20895-2504
Phone
(301) 942-9833
Fax
(301) 942-9837
NPI assigned
Nov 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Authorized official

Name
Dr. Roji Menon, MDNPI 1639269046
Title
President
Phone
(301) 942-9833

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X D0057879 MD Primary

Addresses

Primary practice location

10605 Concord St
Suite 300
Kensington, MD 20895-2504

Mailing address

PO Box 645
Kensington, MD 20895-0645
Phone (301) 942-9833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150205000668 DC Part B Supplier - Clinic/Group Practice 3173848546 Receives reassigned benefits from 2 practitioners
Practice locations: Rockville, MD

National Provider Directory

National Provider Directory

Locations

6010 Executive Blvd
Ste 1040
Rockville, MD 20852
Phone (301) 942-9833

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1245636455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208950645",
            "telephone_number": "301-942-9833",
            "fax_number": "301-942-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 CONCORD ST",
            "address_2": "SUITE 300",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952504",
            "telephone_number": "301-942-9833",
            "fax_number": "301-942-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENON MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-15",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "MENON",
        "authorized_official_first_name": "ROJI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-942-9833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0057879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kensington, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.