Individual provider Active NPI

Mahmudul Haque, M.D.

  • Nephrology Physician
  • Glen Burnie, MD
National Provider Identifier
1639436595
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D0079838 Issued in MD
Practice address
6934 Aviation Blvd Ste F
Glen Burnie, MD 21061-2593
Phone
(410) 760-3588
Fax
(410) 760-3604
NPI assigned
Apr 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 D0079838 MD Primary

Addresses

Primary practice location

6934 Aviation Blvd Ste F
Glen Burnie, MD 21061-2593

Mailing address

1589 Sulphur Spring Rd Ste 109
Baltimore, MD 21227-2542
Phone (443) 575-4880

Other practice location 1

25 Crossroads Dr Ste 205
Owings Mills, MD 21117-5533
Phone (410) 602-7792

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
I20150915000329 MD Practitioner - NephrologyPractitioner - Internal Medicine 8527375104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Nephrology Associates PAGroup PAC ID 2769469006, 60 clinicians

Practice addresses (Care Compare)

25 Crossroads Dr
Suite 205
Owings Mills, MD 21117-5533
Phone (410) 602-7792

Hospital & facility affiliations

  • DaVita Odenton Dialysis Dialysis facility, Odenton, MD, CCN 212711
  • FMC - Odenton Dialysis facility, Odenton, MD, CCN 212677
  • Chesapeake Dialysis Clinic LLC Dialysis facility, Arnold, MD, CCN 212619
  • Fresenius Medical Care Glen Burnie, LLC Dialysis facility, Pasadena, MD, CCN 212756
  • University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043
  • Medstar Harbor Hospital Hospital, Baltimore, MD, CCN 210034
  • Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Nephrology Associates PA Nephrology CurrentSince Jun 1, 2022 Accepting new patients
Clinical Renal Associates, LLC Nephrology CurrentSince Oct 10, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6934 Aviation Blvd
Ste F
Glen Burnie, MD 21061
Phone (410) 760-3588

1589 Sulphur Spring Rd
Ste 109
Halethorpe, MD 21227
Phone (410) 536-5400

25 Crossroads Dr
Ste 205
Owings Mills, MD 21117
Phone (410) 602-7792

825 Town Center Dr
Ste 152
Langhorne, PA 19047
Phone (215) 741-3510

9501 Roosevelt Blvd
Ste 204
Philadelphia, PA 19114
Phone (215) 677-1900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3389/brand/1/csg/21/fhir/r4
  • Direct secure messaging: mahmudulhaque@mana.allscriptsdirect.net
  • Direct secure messaging: mhaque581036@direct.sw.org

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1639436595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 SULPHUR SPRING RD STE 109",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212272542",
            "telephone_number": "443-575-4880",
            "fax_number": "443-575-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6934 AVIATION BLVD STE F",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612593",
            "telephone_number": "410-760-3588",
            "fax_number": "410-760-3604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Crossroads Dr Ste 205",
            "address_purpose": "LOCATION",
            "city": "Owings Mills",
            "state": "MD",
            "postal_code": "211175533",
            "country_code": "US",
            "telephone_number": "410-602-7792",
            "fax_number": "410-602-9889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "MAHMUDUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-17",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0079838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.