Annapolis Nephrology Associates

Organization Active NPI Nephrology Physician · Annapolis, MD

NPI 1356982599 · NPPES record last updated Sep 30, 2019

Key facts

NPI
1356982599
Entity type
Organization (NPI type 2)
Primary specialty
Nephrology Physician 207RN0300X
Legal business name
ANNAPOLIS NEPHROLOGY ASSOCIATES
Practice address
104 Forbes St Ste 102
Annapolis, MD 21401-1543
Phone
(410) 571-8333
Fax
(410) 571-8338
NPI assigned
Sep 30, 2019
Organization subpart
No

Authorized official

Name
Patricia Patterson, RN
Title
Office Manager
Phone
(410) 571-8333

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MD, DC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200123000134 MD Part B Supplier - Clinic/Group Practice 4789918251 Receives reassigned benefits from 1 practitioner
Practice locations: Annapolis, MD
O20200501000047 DC Part B Supplier - Clinic/Group Practice 4789918251 Receives reassigned benefits from 1 practitioner
Practice locations: Bowie, MD

National Provider Directory

Locations

104 Forbes St
Ste 102
Annapolis, MD 21401
Phone (410) 571-8333

304 Harry S Truman Pkwy
#1730
Annapolis, MD 21401

4861 Tesla Dr
Ste H
Bowie, MD 20715
Phone (301) 809-5342

1105 Annapolis Rd
Odenton, MD 21113
Phone (410) 933-0820

1360 Blair Dr
Ste L
Odenton, MD 21113
Phone (410) 674-3918

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8068/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RN0300X Yes

Addresses

Primary practice location

104 Forbes St Ste 102
Annapolis, MD 21401-1543

Mailing address

104 Forbes St Ste 102
Annapolis, MD 21401-1543
Phone (410) 571-8333

Other identifiers

IdentifierTypeStateIssuer
3220801100MedicaidMD

Other providers in Annapolis, MD

All providers in Annapolis, MD · Nephrology Physician in Maryland

Sources for this page

Verify at the official NPI Registry.