Active NPI
American Diagnostics Services LLC
Doing business as TridentCare
- Physiological Laboratory
- Windsor Mill, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physiological Laboratory
- Legal business name
- AMERICAN DIAGNOSTICS SERVICES LLC
- Doing business as
- TridentCare
- Practice address
- 2505 Lord Baltimore Drive
Suite E
Windsor Mill, MD 21244-2639 - Phone
- (410) 295-3565
- Fax
- (443) 842-7264
- NPI assigned
- Jan 31, 2006
- Last updated
- Mar 11, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian C Cuomo
- Title
- Authorized Official/Cfo
- Phone
- (800) 786-8015
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | NU | ||
| Physiological Laboratory | 293D00000X | NU | Primary |
Addresses
Primary practice location
2505 Lord Baltimore Drive
Suite E
Windsor Mill, MD 21244-2639
Mailing address
215 Schilling Cir Ste 114
Hunt Valley, MD 21031-1113
Phone (800) 786-8015
Other practice location 1
4400 140th Ave N Ste 200-230
Clearwater, FL 33762-3832
Phone (800) 786-8015
Other practice location 2
2550 Corporate Exchange Dr Ste 15
Columbus, OH 43231-1660
Phone (614) 431-5455
Other practice location 3
1206 Hartford Ave Ste F
Johnston, RI 02919-7131
Phone (401) 831-8343
Other practice location 4
3801 Computer Dr Ste 103A
Raleigh, NC 27609-6506
Phone (800) 786-8015
Other practice location 5
836 Candia Rd
Manchester, NH 03109-5203
Phone (207) 773-4199
Other practice location 6
7010 S Yale Ave Ste 106
Tulsa, OK 74136-5702
Phone (539) 867-4348
Other practice location 7
115 Gibraltar Rd
Horsham, PA 19044-2303
Phone (215) 957-1280
Other practice location 8
7355 Prairie Falcon Rd
Las Vegas, NV 89128-0801
Phone (800) 786-8015
Other practice location 9
5766 Carmichael Pkwy
Montgomery, AL 36117-2351
Phone (443) 662-4101
Other practice location 10
965 E Yosemite Ave Ste 24
Manteca, CA 95336-5944
Phone (800) 786-8015
Other practice location 11
2141 S El Camino Real Ste A&b
Oceanside, CA 92054-9003
Phone (800) 786-8015
Other practice location 12
3223 Sunset Blvd Ste 100
West Columbia, SC 29169-3200
Phone (803) 772-2411
Other practice location 13
2116 Dabney Rd Ste A1
Richmond, VA 23230-3341
Phone (804) 213-9712
Other practice location 14
20 Technology Dr Ste M2
Brattleboro, VT 05301-9181
Phone (802) 257-9960
Other practice location 15
2502 E University Dr Ste 290
Phoenix, AZ 85034-6932
Phone (800) 786-8015
Other practice location 16
11012 Lin Valle Dr Ste G
Saint Louis, MO 63123-7217
Phone (314) 487-2364
Other practice location 17
10580 Barkley St Ste 415
Overland Park, KS 66212-1850
Phone (913) 901-0140
Other practice location 18
1109 Middleford Rd Ste A
Seaford, DE 19973-3607
Phone (302) 628-4209
Other practice location 19
9110 Leesgate Rd Ste 6
Louisville, KY 40222-5053
Phone (502) 749-1723
Other practice location 20
1001 Virginia Ave Ste 302
Hapeville, GA 30354-1367
Phone (404) 763-7999
Other practice location 21
891 Brighton Ave Ste 32nd
Portland, ME 04102-1056
Phone (207) 253-2446
Other practice location 22
21900 Melrose Ave Ste 1
Southfield, MI 48075-7967
Phone (248) 948-7939
Other practice location 23
7776 S Pointe Pkwy W Ste 150A
Phoenix, AZ 85044-5427
Phone (800) 786-8015
Other practice location 24
133 Fleming St
Piscataway, NJ 08854-3350
Phone (732) 752-9408
Other practice location 25
1134 Industry Dr
Tukwila, WA 98188-4803
Phone (800) 786-8015
Other practice location 26
301 S Perimeter Park Dr Ste 121
Nashville, TN 37211-4128
Phone (615) 333-0904
Other practice location 27
3418 Midcourt Rd Ste 105
Carrollton, TX 75006-4944
Phone (800) 786-8015
Other practice location 28
460 Smith St Ste A
Middletown, CT 06457-1594
Phone (860) 398-5454
Other practice location 29
1660 E Main St Ste 105
Plainfield, IN 46168-1863
Phone (317) 839-2117
Other practice location 30
7700 Brush Hill Rd
Burr Ridge, IL 60527-7544
Phone (630) 521-1010
Other practice location 31
95-202 Halepio Pl
Mililani, HI 96789-5552
Phone (800) 786-8015
Other practice location 32
2 Jonathan Dr
Brockton, MA 02301-5549
Phone (508) 313-0070
Other identifiers 32
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03340952 | Medicaid | NY | |
| 0389137000 | Other | PA | IBC |
| 19531 | Other | PA | HEALTH/SENIOR PARTNERS |
| 499596 | Other | NJ | AETNA |
| 0389137000 | Other | PA | AMERIHEALTH |
| 10026119900 | Medicaid | NE | |
| 10661 | Other | PA | ELDERHEALTH |
| 118225200 | Other | NJ | DEPT. OF LABOR |
| 1639140387 | Medicaid | MI | |
| 1639140387 | Medicaid | MO | |
| 200726830A | Medicaid | KS | |
| 3910006905 | Medicaid | WV | |
| 1035442 | Other | NJ | HORIZON MERCEY |
| 250540997 | Medicaid | DE | |
| 7660804 | Medicaid | NJ | |
| 119726 | Medicaid | AL | |
| 2839585 | Medicaid | OH | |
| 1487954913 | Medicaid | IA | |
| 1639140387 | Medicaid | PA | |
| 7100156790 | Medicaid | KY | |
| 91000047800 | Other | NJ | AMERICHOICE |
| 1639140387 | Medicaid | VA | |
| 417010500 | Medicaid | MD | |
| SL0101 | Medicaid | SC | |
| 200409010A | Medicaid | OK | |
| 200980860A | Medicaid | IN | |
| 2563931 | Other | PA | AETNA |
| 0015026330013 | Medicaid | PA | |
| 038913700 | Other | PA | KEYSTONE |
| 1487954913 | Medicaid | MN | |
| 1523253 | Medicaid | TN | |
| 3081146 | Medicaid | NH |
Other names 1
- TridentCare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NJ, DE, OH, MA, RI, CT, MD, MI, IN, DC, VA, AL, KS, SC, NH, TN, GA, KY, MO, NV, CA, HI, TX, IL, AZ, NC, WA, FL, ME, VT
Enrollment records 31
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040108001087 | PA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Horsham, PA |
| O20050310000514 | NJ | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Piscataway, NJ |
| O20050720000880 | DE | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Seaford, DE |
| O20070608000257 | OH | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Columbus, OH |
| O20080806000184 | MA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Brockton, MA |
| O20080807000231 | RI | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Johnston, RI |
| O20081009000006 | CT | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Middletown, CT |
| O20090123000093 | MD | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 |
1 other NPI on this enrollment Practice locations: Baltimore, MD |
| O20090206000060 | MI | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Southfield, MI |
| O20090825000029 | IN | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Plainfield, IN |
| O20090902000626 | DC | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Baltimore, MD |
| O20090909000222 | VA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 |
Receives reassigned benefits from 1 practitioner Practice locations: Richmond, VA |
| O20100113000556 | AL | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Montgomery, AL |
| O20100119000013 | KS | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Overland Park, KS |
| O20100415000868 | SC | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: West Columbia, SC |
| O20101103000071 | NH | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Manchester, NH |
| O20110215000587 | TN | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 |
Receives reassigned benefits from 18 practitioners Practice locations: Nashville, TN |
| O20110218000214 | GA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Hapeville, GA |
| O20110311000425 | KY | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Louisville, KY |
| O20110609000778 | MO | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Saint Louis, MO |
| O20170314000932 | NV | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 1 practitioner Practice locations: Las Vegas, NV |
| O20170317001102 | CA | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 10 practitioners Practice locations: Oceanside, CA; Manteca, CA |
| O20170327001211 | HI | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 3 practitioners Practice locations: Mililani, HI |
| O20170327001981 | TX | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 36 practitioners Practice locations: Carrollton, TX |
| O20170411001369 | IL | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 19 practitioners Practice locations: Burr Ridge, IL |
| O20170421001581 | AZ | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 6 practitioners Practice locations: Phoenix, AZ |
| O20170502001787 | NC | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 15 practitioners Practice locations: Raleigh, NC |
| O20170509002784 | WA | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 12 practitioners Practice locations: Tukwila, WA |
| O20170519002150 | FL | Part B Supplier - Clinic/Group Practice | 1355241274 |
Receives reassigned benefits from 12 practitioners Practice locations: Clearwater, FL |
| O20210114001001 | ME | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Portland, ME |
| O20210708001451 | VT | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1355241274 | Practice locations: Brattleboro, VT |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba TridentCare
- Physiological Laboratory
- Hunt Valley, MD
- NPI 1487954913
1355241274
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba TridentCare
- Physiological Laboratory
- Hunt Valley, MD
- NPI 1487954913
O20090123000093
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2197465 | N T Screening Services | Certificate of waiver | Oct 25, 2026 |
National Provider Directory
National Provider DirectoryLocations
75 Berlin Rd
Ste 112A
Cromwell, CT 06416
Phone (860) 398-5454
1109 Middleford Rd
Ste A
Seaford, DE 19973
Phone (302) 628-4209
13773 Icot Blvd
Ste 502
Clearwater, FL 33760
Phone (727) 443-0389
9110 Leesgate Rd
Ste 6
Louisville, KY 40222
Phone (267) 532-5146
1372 Hancock St
Ste 302
Quincy, MA 02169
Phone (617) 774-1113
260 Gateway Dr
Ste 15C
Bel Air, MD 21014
Phone (410) 638-5083
891 Brighton Ave
Ste 32ND
Portland, ME 04102
Phone (207) 253-2446
21455 Melrose Ave
Bldg R
Southfield, MI 48075
Phone (248) 948-7939
8030 Old Cedar Ave S
Ste 124
Bloomington, MN 55425
Phone (952) 854-5037
8030 Old Cedar Ave S
Ste 226
Bloomington, MN 55425
Phone (866) 682-5454
8801 E 63rd St
Ste 108
Raytown, MO 64133
Phone (816) 313-6114
230 Goodman Rd E
Ste 203
Southaven, MS 38671
Phone (662) 536-6020
836 Candia Rd
Manchester, NH 03109
Phone (207) 773-4199
7150 N Park Dr
Ste 560
Pennsauken, NJ 08109
6185 Huntley Rd
Ste A
Columbus, OH 43229
Phone (614) 431-5455
13 Armand Hammer Blvd
Pottstown, PA 19464
Phone (610) 323-3100
1206 Hartford Ave
Apt F
Johnston, RI 02919
Phone (401) 228-3464
1206 Hartford Ave
Ste F
Johnston, RI 02919
Phone (401) 831-8343
651 E 4th St
Ste 100
Chattanooga, TN 37403
Phone (423) 648-9863
301 S Perimeter Park Dr
Ste 121
Nashville, TN 37211
Phone (615) 333-0904
555 5th Ave
Ste B
Huntington, WV 25701
Phone (304) 522-3635
Practitioners & affiliated clinicians
Practitioners 111
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Diagnostic Ultrasound Physician
- Seattle, WA
- NPI 1639108046
-
- Clinical Cardiac Electrophysiology Physician
- Spokane, WA
- NPI 1952315186
TN
-
- Body Imaging Physician
- Tacoma, WA
- NPI 1437337458
-
- Diagnostic Radiology Physician
- Joint Base Lewis McChord, WA
- NPI 1497092159
TX
-
- Diagnostic Radiology Physician
- Beverly Hills, CA
- NPI 1689671828
FL, NC, TN, TX
-
- Interventional Cardiology Physician
- Sherman Oaks, CA
- NPI 1225091812
IL, NC, TN, TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773187200000",
"number": "1639140387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 SCHILLING CIR STE 114",
"city": "HUNT VALLEY",
"state": "MD",
"postal_code": "210311113",
"telephone_number": "800-786-8015",
"fax_number": "410-472-1754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2505 LORD BALTIMORE DRIVE",
"address_2": "SUITE E",
"city": "WINDSOR MILL",
"state": "MD",
"postal_code": "212442639",
"telephone_number": "410-295-3565",
"fax_number": "443-842-7264"
}
],
"practiceLocations": [
{
"address_1": "4400 140th Ave N Ste 200-230",
"address_purpose": "LOCATION",
"city": "Clearwater",
"state": "FL",
"postal_code": "337623832",
"country_code": "US",
"telephone_number": "800-786-8015",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2550 Corporate Exchange Dr Ste 15",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432311660",
"country_code": "US",
"telephone_number": "614-431-5455",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1206 Hartford Ave Ste F",
"address_purpose": "LOCATION",
"city": "Johnston",
"state": "RI",
"postal_code": "029197131",
"country_code": "US",
"telephone_number": "401-831-8343",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3801 Computer Dr Ste 103A",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276096506",
"country_code": "US",
"telephone_number": "800-786-8015",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "836 Candia Rd",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "NH",
"postal_code": "031095203",
"country_code": "US",
"telephone_number": "207-773-4199",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7010 S Yale Ave Ste 106",
"address_purpose": "LOCATION",
"city": "Tulsa",
"state": "OK",
"postal_code": "741365702",
"country_code": "US",
"telephone_number": "539-867-4348",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "115 Gibraltar Rd",
"address_purpose": "LOCATION",
"city": "Horsham",
"state": "PA",
"postal_code": "190442303",
"country_code": "US",
"telephone_number": "215-957-1280",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7355 Prairie Falcon Rd",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891280801",
"country_code": "US",
"telephone_number": "800-786-8015",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5766 Carmichael Pkwy",
"address_purpose": "LOCATION",
"city": "Montgomery",
"state": "AL",
"postal_code": "361172351",
"country_code": "US",
"telephone_number": "443-662-4101",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "965 E Yosemite Ave Ste 24",
"address_purpose": "LOCATION",
"city": "Manteca",
"state": "CA",
"postal_code": "953365944",
"country_code": "US",
"telephone_number": "800-786-8015",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2141 S El Camino Real Ste A&b",
"address_purpose": "LOCATION",
"city": "Oceanside",
"state": "CA",
"postal_code": "920549003",
"country_code": "US",
"telephone_number": "800-786-8015",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3223 Sunset Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "West Columbia",
"state": "SC",
"postal_code": "291693200",
"country_code": "US",
"telephone_number": "803-772-2411",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2116 Dabney Rd Ste A1",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232303341",
"country_code": "US",
"telephone_number": "804-213-9712",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "20 Technology Dr Ste M2",
"address_purpose": "LOCATION",
"city": "Brattleboro",
"state": "VT",
"postal_code": "053019181",
"country_code": "US",
"telephone_number": "802-257-9960",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2502 E University Dr Ste 290",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850346932",
"country_code": "US",
"telephone_number": "800-786-8015",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11012 Lin Valle Dr Ste G",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631237217",
"country_code": "US",
"telephone_number": "314-487-2364",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10580 Barkley St Ste 415",
"address_purpose": "LOCATION",
"city": "Overland Park",
"state": "KS",
"postal_code": "662121850",
"country_code": "US",
"telephone_number": "913-901-0140",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1109 Middleford Rd Ste A",
"address_purpose": "LOCATION",
"city": "Seaford",
"state": "DE",
"postal_code": "199733607",
"country_code": "US",
"telephone_number": "302-628-4209",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9110 Leesgate Rd Ste 6",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402225053",
"country_code": "US",
"telephone_number": "502-749-1723",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1001 Virginia Ave Ste 302",
"address_purpose": "LOCATION",
"city": "Hapeville",
"state": "GA",
"postal_code": "303541367",
"country_code": "US",
"telephone_number": "404-763-7999",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "891 Brighton Ave Ste 32nd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041021056",
"country_code": "US",
"telephone_number": "207-253-2446",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "21900 Melrose Ave Ste 1",
"address_purpose": "LOCATION",
"city": "Southfield",
"state": "MI",
"postal_code": "480757967",
"country_code": "US",
"telephone_number": "248-948-7939",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7776 S Pointe Pkwy W Ste 150A",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850445427",
"country_code": "US",
"telephone_number": "800-786-8015",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "133 Fleming St",
"address_purpose": "LOCATION",
"city": "Piscataway",
"state": "NJ",
"postal_code": "088543350",
"country_code": "US",
"telephone_number": "732-752-9408",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1134 Industry Dr",
"address_purpose": "LOCATION",
"city": "Tukwila",
"state": "WA",
"postal_code": "981884803",
"country_code": "US",
"telephone_number": "800-786-8015",
"fax_number": "443-842-7264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "301 S Perimeter Park Dr Ste 121",
"address_purpose": "LOCATION",
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{
"address_1": "7700 Brush Hill Rd",
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{
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"enumeration_date": "2006-01-31",
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"certification_date": "2026-03-11",
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{
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"issuer": "KEYSTONE",
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{
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"identifier": "1487954913",
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{
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"identifier": "1523253",
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{
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"identifier": "3081146",
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"endpoints": [],
"other_names": [
{
"organization_name": "TridentCare",
"code": "3",
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]
}
Other providers in Windsor Mill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.