Individual provider Active NPI

Komal Patel

  • Family Nurse Practitioner
  • Fort Meade, MD
National Provider Identifier
1295373744
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R219909 Issued in MD
Practice address
2480 Llewellyn Ave
Fort Meade, MD 20755-7081
Phone
(301) 677-8800
Fax
(301) 677-8013
NPI assigned
Dec 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R219909 MD
Family Nurse Practitioner 363LF0000X R219909 MD Primary

Addresses

Primary practice location

2480 Llewellyn Ave
Fort Meade, MD 20755-7081

Mailing address

2480 Llewellyn Ave
Fort Meade, MD 20755-7081
Phone (301) 677-8800

Other identifiers 1

IdentifierTypeStateIssuer
R219909MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CVS Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200325000910 DC Practitioner - Nurse Practitioner 0244668275 Reassigns benefits to 1 organization
I20200325002771 MD Practitioner - Nurse Practitioner 0244668275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.37 of 100Reported as group
Quality
74
Improvement activities
40
Cost
72.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R219909MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Feb 27, 2020 Accepting new patients

Locations

2601 Riva Rd
Annapolis, MD 21401
Phone (410) 571-2090

10095 Ward Rd
Dunkirk, MD 20754
Phone (410) 257-0191

6480 Waterloo Rd
Elkridge, MD 21075
Phone (410) 799-0075

7955 Tuckerman Ln
Rockville, MD 20854
Phone (301) 299-3717

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": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1295373744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8800",
            "fax_number": "301-677-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8800",
            "fax_number": "301-677-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KOMAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "R219909",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R219909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R219909",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CVS",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3300 Centennial Ln",
            "city": "Ellicott City",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210423600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Meade, MD

Sources for this page

Verify at the official NPI Registry.