Individual provider Active NPI

Ghousia Sultana, M.D.

  • Internal Medicine Physician
  • Silver Spring, MD
National Provider Identifier
1346294279
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D56691 Issued in MD
Practice address
12107 Heritage Park Cir
Silver Spring, MD 20906-4555
Phone
(301) 949-7000
Fax
(301) 949-7029
NPI assigned
May 22, 2006
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D56691 MD Primary
Hematology (Internal Medicine) Physician 207RH0000X D56691 MD

Addresses

Primary practice location

12107 Heritage Park Cir
Silver Spring, MD 20906-4555

Mailing address

12107 Heritage Park Cir
Silver Spring, MD 20906-4555
Phone (301) 949-7000

Other identifiers 1

IdentifierTypeStateIssuer
699564100MedicaidMD

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040929000201 DC Practitioner - Internal MedicinePractitioner - Hematology 3971572702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12107 Heritage Park Cir
Silver Spring, MD 20906-4555
Phone (301) 949-7000

12107 Heritage Park Circle
Silver Spring, MD 20906-4555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D56691MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Ghousia Sultana, M.D, P.a. Hematology CurrentSince Jul 21, 2004 Accepting new patients
Muslim Community Center CurrentSince Mar 23, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Genesis Eldercare Physician Services LLC Internal Medicine PastSince Mar 24, 2012 Accepting new patients
Genesis Eldercare Physician Services LLC Past Accepting new patients

Locations

12107 Heritage Park Cir
Silver Spring, MD 20906
Phone (301) 949-7000

15200 New Hampshire Ave
Silver Spring, MD 20905
Phone (301) 384-2166

Organizations & group practices 5

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1346294279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12107 HERITAGE PARK CIR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064555",
            "telephone_number": "301-949-7000",
            "fax_number": "301-949-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12107 HERITAGE PARK CIR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064555",
            "telephone_number": "301-949-7000",
            "fax_number": "301-949-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTANA",
        "first_name": "GHOUSIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D56691",
            "primary": true
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "MD",
            "license": "D56691",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699564100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.