NPIMap

Organization Active NPI

Synergy Medical Group LLC

  • Pulmonary Disease Physician
  • Lutherville, MD
National Provider Identifier
1619710191
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
SYNERGY MEDICAL GROUP LLC
Practice address
1205 York Rd Ste 11
Lutherville, MD 21093-6211
Phone
(443) 325-0031
NPI assigned
Jun 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Kamal Salah H Sewaralthahab
Title
Owner
Phone
(443) 325-0031

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

1205 York Rd Ste 11
Lutherville, MD 21093-6211

Mailing address

1205 York Rd Ste 11
Lutherville, MD 21093-6211

Other names 1

  • Synergy Medical Group Pulmonary Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230918003366 MD Part B Supplier - Clinic/Group Practice 0749644177 Receives reassigned benefits from 114 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20231004000513 DC Part B Supplier - Clinic/Group Practice 0749644177 Receives reassigned benefits from 122 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hyattsville, MD; Landover, MD; Lanham, MD; Laurel, MD; Rockville, MD; Silver Spring, MD; Bethesda, MD; Upper Marlboro, MD…
O20250401000422 VA Part B Supplier - Clinic/Group Practice 0749644177 Receives reassigned benefits from 18 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Richmond, VA; Woodbridge, VA

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1619710191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 YORK RD STE 11",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD STE 11",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936211",
            "telephone_number": "443-325-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "SEWARALTHAHAB",
        "authorized_official_first_name": "KAMAL SALAH H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-325-0031"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Medical Group Pulmonary",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.