Individual provider Active NPI

Andrew Kundrat, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Laurel, MD
National Provider Identifier
1366467607
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
D0036716 Issued in MD
Practice address
8356 Sand Cherry LN
Laurel, MD 20723-1087
Phone
(301) 604-3416
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X D0036716 MD Primary

Addresses

Primary practice location

8356 Sand Cherry LN
Laurel, MD 20723-1087

Mailing address

8356 Sand Cherry LN
Laurel, MD 20723-1087
Phone (301) 604-3416

Other identifiers 5

IdentifierTypeStateIssuer
522096682004OtherTRICARE
209821100MedicaidMD
04-58254OtherEVERCARE
9680-0060OtherCAREFIRST BCBS OF DC
522888-03OtherCAREFIRST BCBS OF MD

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 Medicine

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1366467607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8356 SAND CHERRY LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231087",
            "telephone_number": "301-604-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8356 SAND CHERRY LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231087",
            "telephone_number": "301-604-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNDRAT",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0036716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "522096682004",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209821100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "04-58254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF DC",
            "identifier": "9680-0060",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF MD",
            "identifier": "522888-03",
            "state": null
        }
    ],
    "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 Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.