NPIMap

Organization Active NPI

Maryland Endocrine, P.a.

  • Endocrinology, Diabetes & Metabolism Physician
  • Columbia, MD
National Provider Identifier
1316913486
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
MARYLAND ENDOCRINE, P.A.
Practice address
5500 Knoll North Dr Ste 510
Columbia, MD 21045-2365
Phone
(301) 953-2080
Fax
(301) 953-3543
NPI assigned
Feb 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Kimberly Stahl
Title
Practice Administrator
Phone
(301) 953-2080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

5500 Knoll North Dr Ste 510
Columbia, MD 21045-2365

Mailing address

5500 Knoll North Dr Ste 510
Columbia, MD 21045-2365
Phone (301) 953-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050624000242 MD Part B Supplier - Clinic/Group Practice 4082659529 Receives reassigned benefits from 13 practitioners
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory

Locations

10710 Charter Dr
Ste 410
Columbia, MD 21044
Phone (301) 953-2080

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDAAAA

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1316913486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 510",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452365",
            "telephone_number": "301-953-2080",
            "fax_number": "301-953-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 510",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452365",
            "telephone_number": "301-953-2080",
            "fax_number": "301-953-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND ENDOCRINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "STAHL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "301-953-2080"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.