Individual provider Active NPI

Tamil S Kuppusamy, M.D.

  • Nephrology Physician
  • Catonsville, MD
National Provider Identifier
1356349781
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D63188 Issued in MD
Practice address
516 N Rolling Rd
Suite 304
Catonsville, MD 21228-4140
Phone
(410) 744-0890
Fax
(410) 744-2007
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X D63188 MD Primary

Addresses

Primary practice location

516 N Rolling Rd
Suite 304
Catonsville, MD 21228-4140

Mailing address

1589 Sulphur Spring Rd Ste 109
Baltimore, MD 21227-2542
Phone (410) 536-5400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050810000860 MD Practitioner - NephrologyPractitioner - Internal Medicine 7113956046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Nephrology Associates PAGroup PAC ID 2769469006, 60 clinicians

Practice addresses (Care Compare)

5999 Harpers Farm Rd
Suite W250
Columbia, MD 21044-3017
Phone (410) 772-8822

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D63188MDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Nephrology Associates PA Nephrology CurrentSince Jul 1, 2005 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Mid-Atlantic Nephrology Associates PA Nephrology PastSince May 19, 2024 Accepting new patients

Locations

516 N Rolling Rd
Ste 304
Catonsville, MD 21228
Phone (410) 744-0890

5999 Harpers Farm Rd
Ste W250
Columbia, MD 21044
Phone (410) 772-8822

1589 Sulphur Spring Rd
Ste 109
Halethorpe, MD 21227
Phone (410) 536-5400

1205 York Rd
Ste 26
Lutherville, MD 21093
Phone (410) 532-1640

25 Crossroads Dr
Ste 205
Owings Mills, MD 21117
Phone (410) 602-7792

Interoperability endpoints

  • Direct secure messaging: tamilkuppusamy@mana.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1356349781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 SULPHUR SPRING RD STE 109",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212272542",
            "telephone_number": "410-536-5400",
            "fax_number": "410-737-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 N ROLLING RD",
            "address_2": "SUITE 304",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284140",
            "telephone_number": "410-744-0890",
            "fax_number": "410-744-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPUSAMY",
        "first_name": "TAMIL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D63188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

Verify at the official NPI Registry.