NPIMap

Organization Active NPI

Montgomery Endocrinology LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Rockville, MD
National Provider Identifier
1396042941
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
D0059510 Issued in MD
Legal business name
MONTGOMERY ENDOCRINOLOGY LLC
Practice address
50 W Edmonston Dr Ste 600
Rockville, MD 20852-1254
Phone
(301) 251-0662
Fax
(301) 251-7703
NPI assigned
Feb 17, 2011
Last updated
Feb 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Authorized official

Name
Monika Mannan, MDNPI 1558472498
Title
Sole MBR
Phone
(301) 251-0662

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X D0059510 MD Primary

Addresses

Primary practice location

50 W Edmonston Dr Ste 600
Rockville, MD 20852-1254

Mailing address

PO Box 60528
Potomac, MD 20859-0528
Phone (301) 251-0662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110914000561 DC Part B Supplier - Clinic/Group Practice 7012188584 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1396042941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60528",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208590528",
            "telephone_number": "301-251-0662",
            "fax_number": "301-251-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W EDMONSTON DR STE 600",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208521254",
            "telephone_number": "301-251-0662",
            "fax_number": "301-251-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY ENDOCRINOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "MANNAN",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "301-251-0662",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "D0059510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.