Individual provider Active NPI

Edward Philip Taubman, M.D.

  • Internal Medicine Physician
  • Olney, MD
National Provider Identifier
1407859085
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0023459 Issued in MD
Practice address
18109 Prince Philip Dr
Ste 275
Olney, MD 20832-1576
Phone
(301) 774-5400
Fax
(301) 570-4099
NPI assigned
May 27, 2005
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0023459 MD Primary

Addresses

Primary practice location

18109 Prince Philip Dr
Ste 275
Olney, MD 20832-1576

Mailing address

18213 Hillcrest Ave
Olney, MD 20832-1422
Phone (301) 774-5400

Other identifiers 1

IdentifierTypeStateIssuer
129501200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000874 DC Practitioner - Internal Medicine 9931267465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18213 Hillcrest Ave
Olney, MD 20832-1422
Phone (301) 774-5400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0023459MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olney Medical Associates Internal Medicine CurrentSince Oct 1, 1981 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

18109 Prince Philip Dr
Ste 275
Olney, MD 20832
Phone (240) 342-2136

18213 Hillcrest Ave
Olney, MD 20832
Phone (301) 260-7600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1407859085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18213 HILLCREST AVE",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321422",
            "telephone_number": "301-774-5400",
            "fax_number": "301-570-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18109 PRINCE PHILIP DR",
            "address_2": "STE 275",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321576",
            "telephone_number": "301-774-5400",
            "fax_number": "301-570-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUBMAN",
        "first_name": "EDWARD",
        "middle_name": "PHILIP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0023459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129501200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.