Organization Active NPI

Gastroenterology Specialists of Frederick, P.a.

  • Gastroenterology Physician
  • Frederick, MD
National Provider Identifier
1427012053
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROENTEROLOGY SPECIALISTS OF FREDERICK, P.A.
Practice address
85 Thomas Johnson CT
Suite B
Frederick, MD 21702-4331
Phone
(301) 663-9440
Fax
(301) 663-4602
NPI assigned
Apr 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Rifkin, M.D.
Title
Physician-Owner
Phone
(301) 663-9440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

85 Thomas Johnson CT
Suite B
Frederick, MD 21702-4331

Mailing address

85 Thomas Johnson CT
Suite B
Frederick, MD 21702-4331
Phone (301) 663-9440

Other identifiers 1

IdentifierTypeStateIssuer
KG87OtherMDCAREFIRST BLUE CROSS/SHIE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040827000369 MD Part B Supplier - Clinic/Group Practice 8325013907 Receives reassigned benefits from 3 practitioners
Practice locations: Frederick, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0898621Gastroenterology Specialists of Frederick85 Thomas Johnson Court Ste B, Frederick, MD 21702ComplianceDec 3, 2027

National Provider Directory

National Provider Directory

Locations

85 Thomas Johnson Ct
Ste B
Frederick, MD 21702
Phone (301) 663-9440

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427012053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 THOMAS JOHNSON CT",
            "address_2": "SUITE B",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024331",
            "telephone_number": "301-663-9440",
            "fax_number": "301-663-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 THOMAS JOHNSON CT",
            "address_2": "SUITE B",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024331",
            "telephone_number": "301-663-9440",
            "fax_number": "301-663-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY SPECIALISTS OF FREDERICK, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIFKIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN-OWNER",
        "authorized_official_telephone_number": "301-663-9440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS/SHIE",
            "identifier": "KG87",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.