Individual provider Active NPI

Ruth M Kanthula, MD, MPH

  • Pediatrics Physician
  • Fort Washington, MD
National Provider Identifier
1639514995
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0083454 Issued in MD
Practice address
9400 Livingston Rd Ste 320
Fort Washington, MD 20744-4966
Phone
(443) 288-1288
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD045136 DC
Pediatric Infectious Diseases Physician 2080P0208X D0083454 MD
Pediatrics Physician 208000000X D0083454 MD Primary

Addresses

Primary practice location

9400 Livingston Rd Ste 320
Fort Washington, MD 20744-4966

Mailing address

9400 Livingston Rd Ste 320
Fort Washington, MD 20744-4966
Phone (443) 288-1288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20170629000235 DC Practitioner - Pediatric Medicine 8325351646 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0083454MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pediatric Care LLC Pediatrics CurrentSince Aug 25, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jun 5, 2017 Accepting new patients
MGMC, LLC CurrentSince Jun 5, 2017 Accepting new patients

Locations

4200 Wisconsin Ave NW
Washington, DC 20016
Phone (202) 243-3400

4200 Wisconsin Ave NW
Ste 200
Washington, DC 20016
Phone (267) 825-2184

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

9400 Livingston Rd
Ste 320
Ft Washington, MD 20744
Phone (202) 320-4312

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

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.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1639514995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 LIVINGSTON RD STE 320",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207444966",
            "telephone_number": "443-288-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 LIVINGSTON RD STE 320",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207444966",
            "telephone_number": "443-288-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTHULA",
        "first_name": "RUTH",
        "middle_name": "M",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD045136",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "MD",
            "license": "D0083454",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0083454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, MD

Sources for this page

Verify at the official NPI Registry.