Active NPI
Khondker M Shamsuzzoha, M.D.
- Anesthesiology Physician
- Frederick, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- D 0057162
- Practice address
- 196 Thomas Johnson Dr
Suite # 215
Frederick, MD 21702-4397 - Phone
- (301) 668-9988
- Fax
- (301) 668-9977
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | D 0057162 | MD | Primary |
Addresses
Primary practice location
196 Thomas Johnson Dr
Suite # 215
Frederick, MD 21702-4397
Mailing address
6567 Forsythia St
Springfield, VA 22150-1167
Phone (703) 822-0845
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050085552 | Other | MEDICARE RAILROAD | |
| 754401400 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090831000634 | VA | Practitioner - Anesthesiology | 3971658790 | Reassigns benefits to 2 organizations |
| I20091007000437 | MD | Practitioner - Anesthesiology | 3971658790 | Reassigns benefits to 5 organizations |
| I20151202002266 | DC | Practitioner - Anesthesiology | 3971658790 | Reassigns benefits to 4 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D 0057162 | MD | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Global Anesthesia Services LLC | Anesthesiology | Current | Accepting new patients |
| First Colonies Anesthesia Associates, LLC | Anesthesiology | Current | Accepting new patients |
| American Anesthesiology of Virginia PC | Anesthesiology | Current | Accepting new patients |
| Orthomed Staffing LLC | Anesthesiology | Current | Accepting new patients |
| Northstar Anesthesia of Virginia, LLC | Anesthesiology | Current | Accepting new patients |
| American Anesthesiology of Virginia, PC | Anesthesiology | Current | Accepting new patients |
| Francu One LLC | Current | Accepting new patients | |
| Capital Pain Management & Anesthesia Associates, LLC | Anesthesiology | Past | Accepting new patients |
| Privium Consultants LLC | Past | Accepting new patients | |
| Newbridge Surgery Center at Prince Frederick, LLC | Past | Accepting new patients | |
| Northern Virginia Anesthesia Assoc. | Anesthesiology | Past | Accepting new patients |
Locations
626C Admiral Dr
#324
Annapolis, MD 21401
9001 Woodyard Rd
Ste B
Clinton, MD 20735
Phone (301) 868-4950
6816 Deerpath Rd
Elkridge, MD 21075
Phone (410) 757-5019
400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300
4991 New Design Rd
Ste 103
Frederick, MD 21703
Phone (301) 363-5858
308 Hospital Dr
Ste 102
Glen Burnie, MD 21061
Phone (410) 760-8100
6710 Oxon Hill Rd
Ste 150
Oxon Hill, MD 20745
Phone (240) 461-6999
1838 Greene Tree Rd
Ste 370
Pikesville, MD 21208
Phone (202) 221-8442
11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770
1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230
8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688
2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000
736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124
541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700
3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037
3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395
19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950
Organizations & group practices 12
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.
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- Ambulatory Surgical Clinic/Center
- Prince Frederick, MD
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Anesthesiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348704000000",
"number": "1386795573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6567 FORSYTHIA ST",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "221501167",
"telephone_number": "703-822-0845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 THOMAS JOHNSON DR",
"address_2": "SUITE # 215",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024397",
"telephone_number": "301-668-9988",
"fax_number": "301-668-9977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAMSUZZOHA",
"first_name": "KHONDKER",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2012-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MD",
"license": "D 0057162",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "050085552",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "754401400",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.