Mira Mace Medical Group PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MIRA MACE MEDICAL GROUP PA

Practice address

11810 Grand Park Ave Ste 500
North Bethesda, MD 20852-8679

Phone

(332) 296-0021

NPI assigned

Aug 21, 2025

Organization subpart

No

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

Authorized official

Name

Prashant Kumar

Title

Operations Administrator

Phone

(332) 296-0021

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, GA, NH, FL, CO, WA, IL, IN, PA, DC, MO, OH, MN, SC, OK, TN, NC, MD, AZ, NJ20 enrollments

Enrollment records 20

Locations

Practitioners 5

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

• Jenny Marie Griffin, D.O.

  • Family Medicine Physician
  • High Point, NC
  • NPI 1336282011

  AZ, CO, GA, NH, SC, TX, WA

  Medicare reassignment Care Compare group NPD
• Fatima Yousef Hussein, MD

  • Family Medicine Physician
  • Venice, CA
  • NPI 1245233717

  AZ, DC, FL, GA, IL, IN, MD, MN, MO, NC, OH, OK, PA, SC, TN, TX

  Medicare reassignment Care Compare group NPD
• Narendra K Garg, M.D.

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1134136369

  FL, TX

  Medicare reassignment NPD
• Harmandeep Dhillon

  • Family Medicine Physician
  • West Islip, NY
  • NPI 1447749890

  NJ

  Medicare reassignment
• Trisha Antoine, MSN, FNP

  • Nurse Practitioner
  • Dracut, MA
  • NPI 1033589858
  NPD

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1487532289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111B S GOVERNORS AVE STE 39475",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199046903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11810 GRAND PARK AVE STE 500",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208528679",
            "telephone_number": "332-296-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA MACE MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "PRASHANT",
        "authorized_official_title_or_position": "OPERATIONS ADMINISTRATOR",
        "authorized_official_telephone_number": "332-296-0021"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate Meadows
• Medlink Mt LLC
• Joseph Michaels V, MD
• Mid Atlantic Pediatric Partners
• Minde Inc.
• Mkim Dental LLC
• Caroline Djouom Mogo, PMHNP
• Josephine Moore, FNP-BC
• Kristen Hadassah Moreh, RDN
• Jessica Durkin Morgan, NP

• Family Medicine Physician in North Bethesda, MD
• Providers in North Bethesda, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.