NPIMap

Organization Active NPI

Synergy Medical Group, LLC

  • Optometrist
  • Timonium, MD
National Provider Identifier
1689464000
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SYNERGY MEDICAL GROUP, LLC
Practice address
1205 York Rd Ste 11
Timonium, MD 21093-6211
Phone
(443) 325-0031
NPI assigned
May 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Kamal Salah H SewaralthahabNPI 1689939035
Title
Owner
Phone
(571) 338-7460

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1205 York Rd Ste 11
Timonium, MD 21093-6211

Mailing address

1205 York Rd Ste 11
Timonium, MD 21093-6211
Phone (443) 325-0031

Other names 1

  • Synergy Medical Group, LLC Optometry Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230918003366 MD Part B Supplier - Clinic/Group Practice 0749644177 Receives reassigned benefits from 114 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20231004000513 DC Part B Supplier - Clinic/Group Practice 0749644177 Receives reassigned benefits from 122 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hyattsville, MD; Landover, MD; Lanham, MD; Laurel, MD; Rockville, MD; Silver Spring, MD; Bethesda, MD; Upper Marlboro, MD…
O20250401000422 VA Part B Supplier - Clinic/Group Practice 0749644177 Receives reassigned benefits from 18 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Richmond, VA; Woodbridge, VA

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory
Tax ID family
Synergy Medical Group LLC121 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1689464000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 YORK RD STE 11",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210936211",
            "telephone_number": "443-325-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD STE 11",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210936211",
            "telephone_number": "443-325-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "SEWARALTHAHAB",
        "authorized_official_first_name": "KAMAL SALAH H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-338-7460"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Medical Group, LLC Optometry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Timonium, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.