Individual provider Active NPI

Kruti Vyas, MD

  • Family Medicine Physician
  • Frederick, MD
National Provider Identifier
1639737158
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0093874 Issued in MD
Practice address
63 Thomas Johnson Dr Ste E
Frederick, MD 21702-4399
Phone
(301) 694-7600
Fax
(301) 228-2500
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0093874 MD Primary

Addresses

Primary practice location

63 Thomas Johnson Dr Ste E
Frederick, MD 21702-4399

Mailing address

63 Thomas Johnson Dr Ste E
Frederick, MD 21702-4399
Phone (301) 694-7600

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
I20221021002716 MD Practitioner - Family Practice 0749518439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians

Practice addresses (Care Compare)

110 Baughmans LN
Suite 140
Frederick, MD 21702-4649
Phone (240) 215-1138

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

56 Thomas Johnson Dr
Frederick, MD 21702-4599
Phone (301) 694-3111

610 Solarex CT
Frederick, MD 21703-8624
Phone (301) 682-5500

63 Thomas Johnson Dr
Suite E
Frederick, MD 21702-4399
Phone (301) 694-7600

Hospital & facility affiliations

  • Frederick Health Home Care Home health agency, Frederick, MD, CCN 217034
  • Frederick Health Hospice Hospice, Frederick, MD, CCN 211516
  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0093874MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Care Center LLC CurrentSince Aug 22, 2022 Accepting new patients
Privia Care Center LLC CurrentSince Aug 22, 2022 Accepting new patients
Menocal Medical Services PA Family Medicine Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Nova Physician Wellness Center PLLC Family Medicine Past Accepting new patients

Locations

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

63 Thomas Johnson Dr
Ste E
Frederick, MD 21702
Phone (301) 687-7053

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kruti.vyas.1@8042.direct.athenahealth.com

Organizations & group practices 6

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 5

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1639737158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 THOMAS JOHNSON DR STE E",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024399",
            "telephone_number": "301-694-7600",
            "fax_number": "301-228-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 THOMAS JOHNSON DR STE E",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024399",
            "telephone_number": "301-694-7600",
            "fax_number": "301-228-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "KRUTI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0093874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.