Surya P Mundra, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D21776 Issued in MD

Practice address

8021 Ritchie Hwy
Pasadena, MD 21122-1016

Phone

(410) 761-8200

Fax

(410) 761-1331

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Maryland Family Care, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1598718256

  Internal Medicine

  Medicare reassignment NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295744712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8021 RITCHIE HWY",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221016",
            "telephone_number": "410-761-8200",
            "fax_number": "410-761-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8021 RITCHIE HWY",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221016",
            "telephone_number": "410-761-8200",
            "fax_number": "410-761-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDRA",
        "first_name": "SURYA",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D21776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD OF MARYLAND",
            "identifier": "34342007",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "03152154647401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Moyer, PTA
• Michael Moyer
• Wazaino Msimbwa
• Diana Mulvey, CRNP
• Ali Mumtaz, D.P.M.
• Myeyedr Optometry of Maryland, LLC
• Karen Mygil, DDS
• Nabil Badro, M.D., P.a.
• Lucas Naden, L.AC, M.AC, DIPL.AC
• Patries Esi Nagbe

• Internal Medicine Physician in Pasadena, MD
• Providers in Pasadena, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.