NPIMap

Organization Active NPI

Capital Primary and Geriatric Care, LLC

  • Internal Medicine Physician
  • Rockville, MD
National Provider Identifier
1689936304
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD432933 Issued in MD
Legal business name
CAPITAL PRIMARY AND GERIATRIC CARE, LLC
Practice address
100 1St St
Suite 130
Rockville, MD 20851-1314
Phone
(301) 258-1904
Fax
(301) 339-7722
NPI assigned
Jun 8, 2012
Last updated
Jun 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Authorized official

Name
Mrs. Tina Aloysius
Title
Manager
Phone
(301) 258-1904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD432933 MD Primary

Addresses

Primary practice location

100 1St St
Suite 130
Rockville, MD 20851-1314

Mailing address

100 1St St
Suite 130
Rockville, MD 20851-1314
Phone (301) 258-1904

Other identifiers 1

IdentifierTypeStateIssuer
024810000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, DE, VA, PA5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20120628000533 DC Part B Supplier - Clinic/Group Practice 5597920389 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville, MD; Silver Spring, MD; Montgomery Village, MD; Laurel, MD; Gaithersburg, MD; Bethesda, MD; Arlington, VA
O20120801000765 MD Part B Supplier - Clinic/Group Practice 5597920389 Receives reassigned benefits from 2 practitioners
Practice locations: Bel Air, MD; Rising Sun, MD; Randallstown, MD; Laurel, MD; Forest Hill, MD; Easton, MD; Columbia, MD; Baltimore, MD
O20231026002313 DE Part B Supplier - Clinic/Group Practice 5597920389 Practice locations: Wilmington, DE
O20231122000775 VA Part B Supplier - Clinic/Group Practice 5597920389 Receives reassigned benefits from 1 practitioner
Practice locations: Alexandria, VA; Leesburg, VA
O20240402002140 PA Part B Supplier - Clinic/Group Practice 5597920389 Receives reassigned benefits from 1 practitioner
Practice locations: Darby, PA; Warminster, PA

National Provider Directory

National Provider Directory

Locations

701 N Clayton St
Ste 225
Wilmington, DE 19805

1500 Lansdowne Ave
Ste 1
Darby, PA 19023
Phone (610) 237-2531

Practitioners & affiliated clinicians

Practitioners 3

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": "1339113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1689936304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 1ST ST",
            "address_2": "SUITE 130",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208511314",
            "telephone_number": "301-258-1904",
            "fax_number": "301-339-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 1ST ST",
            "address_2": "SUITE 130",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208511314",
            "telephone_number": "301-258-1904",
            "fax_number": "301-339-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL PRIMARY AND GERIATRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-08",
        "status": "A",
        "authorized_official_last_name": "ALOYSIUS",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "301-258-1904",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "MD432933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024810000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.