NPIMap

Individual provider Active NPI

Irfan Shukrullah, M.D

  • Nephrology Physician
  • Baltimore, MD
National Provider Identifier
1528200201
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D0076790 Issued in MD
Practice address
6830 Hospital Dr
Suite 204
Baltimore, MD 21237-4373
Phone
(443) 559-5063
Fax
(443) 559-5078
NPI assigned
Mar 27, 2009
Last updated
Jun 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X D0076790 MD Primary

Addresses

Primary practice location

6830 Hospital Dr
Suite 204
Baltimore, MD 21237-4373

Mailing address

3150 N Ridge Rd
Apt 204
Ellicott City, MD 21043-3390
Phone (404) 543-5535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150803002633 MD Practitioner - Nephrology 1951557891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Kidney Group PAGroup PAC ID 2860384328, 7 clinicians

Practice addresses (Care Compare)

6830 Hospital Dr
Suite 204
Baltimore, MD 21237-4377
Phone (443) 559-5063

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0076790MDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Kidney Group PA Nephrology CurrentSince Aug 1, 2015 Accepting new patients
Maryland Kidney Associates, LLC Nephrology Past Accepting new patients

Locations

6830 Hospital Dr
Ste 204
Rosedale, MD 21237
Phone (410) 391-6131

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

9411 Philadelphia Rd
Ste A
Rosedale, MD 21237
Phone (410) 823-0030

7600 Osler Dr
Ste 111
Towson, MD 21204
Phone (410) 321-5749

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

Interoperability endpoints

  • Direct secure messaging: ishukrullah34448@direct.acumenmd.com
  • Direct secure messaging: ishukrullah83997@direct.umm.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1528200201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N RIDGE RD",
            "address_2": "APT 204",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433390",
            "telephone_number": "404-543-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 HOSPITAL DR",
            "address_2": "SUITE 204",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374373",
            "telephone_number": "443-559-5063",
            "fax_number": "443-559-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKRULLAH",
        "first_name": "IRFAN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0076790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.