Individual provider Active NPI

Manjit Kaur Risam, M.D.

  • Gynecology Physician
  • Bowie, MD
National Provider Identifier
1306830047
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
D0032735 Issued in MD
Practice address
3060 Mitchellville Rd
210
Bowie, MD 20716-1389
Phone
(301) 249-4090
Fax
(301) 390-1344
NPI assigned
Sep 8, 2005
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0032735 MD
Gynecology Physician 207VG0400X D0032735 MD Primary

Addresses

Primary practice location

3060 Mitchellville Rd
210
Bowie, MD 20716-1389

Mailing address

8110 Maple Lawn Blvd Ste 235
Fulton, MD 20759-2694
Phone (301) 340-8339

Other identifiers 11

IdentifierTypeStateIssuer
405671000MedicaidMD
521854007OtherMDALL OTHER INS CO. ID #
04830OtherAMERIGROUP ID#
0700031OtherUNITEDHEALTHCARE ID #
4089037OtherAETNA PROVIDER #
41985902OtherMDCAREFIRST MD ID #
46565OtherMAMSI ID#
27866OtherMDJOHN HOPKINS EHP ID #
203249OtherVAHEALTHKEEPERS ID#
495982OtherNCPPO ID #
56760001OtherDCCAREFIRST DC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address manjit.risam.p1@direct.cwcare.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014001694 DC Practitioner - Obstetrics/Gynecology 8729183678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8110 Maple Lawn Blvd
Suite 235
Fulton, MD 20759-2693

8110 Maple Lawn Blvd
Suite 235
Fulton, MD 20759-2694

Merit-based Incentive Payment System (MIPS)

Final score
43.1 of 100Reported as group
Quality
7.9
Improvement activities
40
Cost
79.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0032735MDMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Women's Care, L.L.C. Obstetrics & Gynecology CurrentSince Apr 1, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

8110 Maple Lawn Blvd
Ste 235
Fulton, MD 20759

9711 Medical Center Dr
Ste 109
Rockville, MD 20850
Phone (301) 762-5501

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1306830047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 MAPLE LAWN BLVD STE 235",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592694",
            "telephone_number": "301-340-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 MITCHELLVILLE RD",
            "address_2": "210",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161389",
            "telephone_number": "301-249-4090",
            "fax_number": "301-390-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISAM",
        "first_name": "MANJIT",
        "middle_name": "KAUR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0032735",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MD",
            "license": "D0032735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405671000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL OTHER INS CO. ID #",
            "identifier": "521854007",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP ID#",
            "identifier": "04830",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE ID #",
            "identifier": "0700031",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "4089037",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD ID #",
            "identifier": "41985902",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI ID#",
            "identifier": "46565",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN HOPKINS EHP ID #",
            "identifier": "27866",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHKEEPERS ID#",
            "identifier": "203249",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO ID #",
            "identifier": "495982",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC",
            "identifier": "56760001",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manjit.risam.p1@direct.cwcare.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3060 Mitchellville Rd",
            "address_2": "210",
            "city": "Bowie",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207161389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.