Individual provider Active NPI

Bharathi Gowda, MD

  • Obstetrics & Gynecology Physician
  • Glen Burnie, MD
National Provider Identifier
1568532208
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D23250 Issued in MD
Practice address
1410 Crain Hwy N.W.
Suite No 4a
Glen Burnie, MD 21061
Phone
(410) 760-5885
Fax
(410) 760-6683
NPI assigned
Nov 9, 2006
Last updated
Jun 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0023250 MD
Obstetrics & Gynecology Physician 207V00000X D23250 MD Primary

Addresses

Primary practice location

1410 Crain Hwy N.W.
Suite No 4a
Glen Burnie, MD 21061

Mailing address

1410 Crain Hwy N.W.
Suite 4a
Glen Burnie, MD 21061
Phone (410) 760-5885

Other identifiers 1

IdentifierTypeStateIssuer
255241800MedicaidMD

Other names 1

  • Bharathi Prabhakar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090122000368 MD Practitioner - Obstetrics/Gynecology 3971666868 Reassigns benefits to 1 organization
Practice locations: Glen Burnie, MD

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0023250MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jan 1, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

41680 Miss Bessie Dr
Leonardtown, MD 20650
Phone (301) 997-0055

Interoperability endpoints

  • Direct secure messaging: bharathi.gowda.1@13748.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1568532208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 CRAIN HWY N.W.",
            "address_2": "SUITE 4A",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-5885",
            "fax_number": "410-760-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 CRAIN HWY N.W.",
            "address_2": "SUITE NO 4A",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-5885",
            "fax_number": "410-760-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWDA",
        "first_name": "BHARATHI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0023250",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D23250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255241800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BHARATHI",
            "last_name": "PRABHAKAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.