Active NPI
Komal Patel
- Family Nurse Practitioner
- Fort Meade, MD
National Provider Identifier
1295373744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R219909
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R219909 | Medicaid | MD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | CVS | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 77.37 of 100
- Quality
- 74
- Improvement activities
- 40
- Cost
- 72.24
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R219909 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minuteclinic LLC | Family | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.