Individual provider Active NPI

Atiya H Gopalani, M.D.

  • Gynecology Physician
  • Olney, MD
National Provider Identifier
1407894124
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
D36981 Issued in MD
Practice address
18111 Prince Philip Dr
Ste 126
Olney, MD 20832-1513
Phone
(301) 570-4866
Fax
(301) 570-0236
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X D36981 MD Primary

Addresses

Primary practice location

18111 Prince Philip Dr
Ste 126
Olney, MD 20832-1513

Mailing address

18111 Prince Philip Dr
Ste 126
Olney, MD 20832-1513
Phone (301) 570-4866

Other identifiers 4

IdentifierTypeStateIssuer
3782401608OtherMDBC MD
40850001OtherDCBC DC/METRO
296531301MedicaidMD
833373OtherMDUHC GROUP

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
I20040929001026 DC Practitioner - Obstetrics/Gynecology 4284603911 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Aug 18, 2016 Accepting new patients
Privia Medical Group, LLC Gynecology CurrentSince Aug 18, 2016 Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

18111 Prince Philip Dr
Ste 126
Olney, MD 20832
Phone (301) 570-4866

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1407894124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "STE 126",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321513",
            "telephone_number": "301-570-4866",
            "fax_number": "301-570-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "STE 126",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321513",
            "telephone_number": "301-570-4866",
            "fax_number": "301-570-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPALANI",
        "first_name": "ATIYA",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MD",
            "license": "D36981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC MD",
            "identifier": "3782401608",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC DC/METRO",
            "identifier": "40850001",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296531301",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC GROUP",
            "identifier": "833373",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.