NPIMap

Organization Active NPI

Capital Area Internal Medicine Inc

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1699528943
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAPITAL AREA INTERNAL MEDICINE INC
Practice address
3581 Old Washington Rd # C
Waldorf, MD 20602-3270
Phone
(703) 255-6010
Fax
(703) 255-6011
NPI assigned
Apr 8, 2024
Last updated
Aug 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Sree Lakshmi Gogineni, MDNPI 1386603736
Title
Owner/Authorized Official
Phone
(703) 255-6010

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Obesity Medicine (Internal Medicine) Physician 207RB0002X NU
Obesity Medicine (Preventive Medicine) Physician 2083B0002X NU

Addresses

Primary practice location

3581 Old Washington Rd # C
Waldorf, MD 20602-3270

Mailing address

44121 Leesburg Pike Ste 250
Ashburn, VA 20147-5674
Phone (703) 255-6010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240903002818 MD Part B Supplier - Clinic/Group Practice 0749246858 Receives reassigned benefits from 1 practitioner
Practice locations: Waldorf, MD

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Capital Area Internal Medicine Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1699528943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44121 LEESBURG PIKE STE 250",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475674",
            "telephone_number": "703-255-6010",
            "fax_number": "703-255-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 OLD WASHINGTON RD # C",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023270",
            "telephone_number": "703-255-6010",
            "fax_number": "703-255-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL AREA INTERNAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "GOGINENI",
        "authorized_official_first_name": "SREE",
        "authorized_official_middle_name": "LAKSHMI",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "703-255-6010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.