Active NPI
Susan Madonna, D.O.
- Family Medicine Physician
- Laurel, MD
National Provider Identifier
1366427940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H59597
- Practice address
- 8871 Gorman Rd
Suite 300
Laurel, MD 20723-5877 - Phone
- (301) 498-3150
- Fax
- (301) 490-2411
- NPI assigned
- Dec 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H59597 | MD | Primary |
Addresses
Primary practice location
8871 Gorman Rd
Suite 300
Laurel, MD 20723-5877
Mailing address
9649 Belair Rd
Second Floor
Baltimore, MD 21236-1100
Phone (410) 248-2650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H59597 | MD | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296777600000",
"number": "1366427940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9649 BELAIR RD",
"address_2": "SECOND FLOOR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212361100",
"telephone_number": "410-248-2650",
"fax_number": "410-248-2656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8871 GORMAN RD",
"address_2": "SUITE 300",
"city": "LAUREL",
"state": "MD",
"postal_code": "207235877",
"telephone_number": "301-498-3150",
"fax_number": "301-490-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADONNA",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-07",
"last_updated": "2011-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "H59597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.