Individual provider Active NPI

Caryl Glenda Mussenden, M.D.

  • Gynecology Physician
  • Lanham, MD
National Provider Identifier
1265585483
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
D0019555 Issued in MD
Practice address
9811 Greenbelt Rd
Suite 104
Lanham, MD 20706-2215
Phone
(301) 552-1111
Fax
(301) 552-9555
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X D0019555 MD Primary

Addresses

Primary practice location

9811 Greenbelt Rd
Suite 104
Lanham, MD 20706-2215

Mailing address

9811 Greenbelt Rd
Suite 104
Lanham, MD 20706-2215
Phone (301) 552-1111

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
I20040520000807 DC Practitioner - Obstetrics/Gynecology 3375534175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0019555MDMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265585483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 GREENBELT RD",
            "address_2": "SUITE 104",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062215",
            "telephone_number": "301-552-1111",
            "fax_number": "301-552-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 GREENBELT RD",
            "address_2": "SUITE 104",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062215",
            "telephone_number": "301-552-1111",
            "fax_number": "301-552-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSENDEN",
        "first_name": "CARYL",
        "middle_name": "GLENDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MD",
            "license": "D0019555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.