NPIMap

Organization Active NPI

Family Medcare, LLC

  • Health Service Clinic/Center
  • Bryans Road, MD
National Provider Identifier
1346421039
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
FAMILY MEDCARE, LLC
Practice address
8030 Matthews Rd
Ste 105
Bryans Road, MD 20616-4265
Phone
(301) 283-2800
NPI assigned
Nov 21, 2007
Last updated
Aug 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Authorized official

Name
Rudy Juburi, M.D.NPI 1477598761
Title
Owner
Phone
(301) 283-2800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

8030 Matthews Rd
Ste 105
Bryans Road, MD 20616-4265

Mailing address

PO Box 1205
Bryans Road, MD 20616-1205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081204000230 MD Part B Supplier - Clinic/Group Practice 4183694979 Receives reassigned benefits from 3 practitioners
Practice locations: White Plains, MD

National Provider Directory

National Provider Directory

Locations

4225 Altamont Pl
Ste 203
White Plains, MD 20695
Phone (301) 375-8080

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1346421039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1205",
            "city": "BRYANS ROAD",
            "state": "MD",
            "postal_code": "206161205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 MATTHEWS RD",
            "address_2": "STE 105",
            "city": "BRYANS ROAD",
            "state": "MD",
            "postal_code": "206164265",
            "telephone_number": "301-283-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "JUBURI",
        "authorized_official_first_name": "RUDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-283-2800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryans Road, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.