Ronald Shore MD PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

RONALD SHORE MD PA

Practice address

4701 Randolph Rd Ste 207
Rockville, MD 20852-2261

Phone

(410) 872-9188

Fax

(410) 872-9169

NPI assigned

Oct 30, 2007

Last updated

Apr 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David M Fish

Title

VP Billing

Phone

(410) 872-9188

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Ronald Shore, M.D.

  • Dermatology Physician
  • Rockville, MD
  • NPI 1144258757

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1649459322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD STE 207",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522261",
            "telephone_number": "410-872-9188",
            "fax_number": "410-872-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD STE 207",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522261",
            "telephone_number": "410-872-9188",
            "fax_number": "410-872-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD SHORE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP BILLING",
        "authorized_official_telephone_number": "410-872-9188",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6792",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "070015957",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8216RN",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sierra Romero
• Shelsea Romney
• Jocelyn Romulus
• Sherin A Ronaghian, MD
• Ronald F. Gravitz, P.a.
• Jacqueline Rondeau
• Kelsey L Rood, LCPC
• Kristi Rood
• Clarissa Rooks
• Rooted in Function LLC

• Dermatology Physician in Rockville, MD
• Providers in Rockville, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.

Verify at the official NPI Registry.