NPIMap

Organization Active NPI

Maryland Medical Group, Inc

  • Internal Medicine Physician
  • Rockville, MD
National Provider Identifier
1467173203
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MARYLAND MEDICAL GROUP, INC
Practice address
10110 Molecular Dr Ste 114
Rockville, MD 20850-7538
Phone
(301) 780-4745
Fax
(301) 605-7550
NPI assigned
Sep 9, 2022
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Mr. Truong Bao, M.D.NPI 1972553394
Title
Ceo
Phone
(301) 780-4745

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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

10110 Molecular Dr Ste 114
Rockville, MD 20850-7538

Mailing address

10110 Molecular Dr Ste 114
Rockville, MD 20850-7538
Phone (301) 780-4745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221102000043 DC Part B Supplier - Clinic/Group Practice 1052788114 Receives reassigned benefits from 18 practitioners
Practice locations: Rockville, MD
O20230710000377 MD DME Supplier - Physician - Podiatry 1052788114 Practice locations: Rockville, 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
21D2320136Maryland Medical Group Inc10110 Molecular Dr #114, Rockville, MD 20850Certificate of waiverMar 12, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.608025

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1467173203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 MOLECULAR DR STE 114",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507538",
            "telephone_number": "301-780-4745",
            "fax_number": "301-605-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 MOLECULAR DR STE 114",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507538",
            "telephone_number": "301-780-4745",
            "fax_number": "301-605-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "BAO",
        "authorized_official_first_name": "TRUONG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-780-4745",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "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 Apr 29, 2024; 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.