Organization Active NPI

Madhavi Hubbly MD

  • Primary Care Clinic/Center
  • Gaithersburg, MD
National Provider Identifier
1669860128
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MADHAVI HUBBLY MD
Practice address
12116 Darnestown Rd Ste L5
Gaithersburg, MD 20878-2227
Phone
(301) 528-4134
Fax
(301) 569-7358
NPI assigned
Jan 6, 2015
Last updated
May 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

Name
Madhavi Hubbly, MDNPI 1710074521
Title
Physician
Phone
(301) 528-4134

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X D62562 MD
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

12116 Darnestown Rd Ste L5
Gaithersburg, MD 20878-2227

Mailing address

12116 Darnestown Rd Ste L5
Gaithersburg, MD 20878-2227
Phone (301) 528-4134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150413002020 DC Part B Supplier - Clinic/Group Practice 4688992167 Receives reassigned benefits from 2 practitioners
Practice locations: Gaithersburg, MD

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2093108Madhavi Hubbly, MD, LLC12116 Darnestown Road Suite L5, Gaithersburg, MD 20878Certificate of waiverMar 19, 2027

National Provider Directory

National Provider Directory

Locations

12116 Darnestown Rd
#L5
Gaithersburg, MD 20878
Phone (301) 528-4134

12116 Darnestown Rd
Ste L5
Gaithersburg, MD 20878
Phone (301) 528-4134

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFGADA

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1669860128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12116 DARNESTOWN RD STE L5",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782227",
            "telephone_number": "301-528-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12116 DARNESTOWN RD STE L5",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782227",
            "telephone_number": "301-528-4134",
            "fax_number": "301-569-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADHAVI HUBBLY MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-06",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "HUBBLY",
        "authorized_official_first_name": "MADHAVI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "301-528-4134",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D62562",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.