Individual provider Active NPI

Farzana Ajmal, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Germantown, MD
National Provider Identifier
1497841563
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
D0065301 Issued in MD
Practice address
19731 Executive Park Cir
Germantown, MD 20874-2642
Phone
(301) 540-1332
Fax
(301) 576-7146
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X D0065301 MD Primary

Addresses

Primary practice location

19731 Executive Park Cir
Germantown, MD 20874-2642

Mailing address

19731 Executive Park Cir
Germantown, MD 20874-2642
Phone (301) 540-1332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070816000515 MD Practitioner - Family Practice 7315039658 Reassigns benefits to 1 organization
I20071112000395 DC Practitioner - Family PracticePractitioner - Geriatric Medicine 7315039658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Med Clinic PAGroup PAC ID 7012083033, 2 clinicians

Practice addresses (Care Compare)

13225 Executive Park Ter
Germantown, MD 20874-2648
Phone (301) 540-1332

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
My Med Clinic PA Current Accepting new patients
My Med Clinic PA Geriatric Medicine CurrentSince Aug 27, 2008 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

19731 Executive Park Cir
Germantown, MD 20874
Phone (301) 540-1332

19506 Doctors Dr
Germantown, MD 20874
Phone (301) 515-4311

13225 Executive Park Ter
Germantown, MD 20874
Phone (202) 584-9346

Interoperability endpoints

  • Direct secure messaging: farzana.ajmal.1@20968.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20968/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1497841563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19731 EXECUTIVE PARK CIR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742642",
            "telephone_number": "301-540-1332",
            "fax_number": "301-576-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19731 EXECUTIVE PARK CIR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742642",
            "telephone_number": "301-540-1332",
            "fax_number": "301-576-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJMAL",
        "first_name": "FARZANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0065301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.