Active NPI
Thomas B Haywood, MD
- Cardiovascular Disease Physician
- Waldorf, MD
National Provider Identifier
1699746271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD040202E
- Practice address
- 12070 Old Line Ctr
Suite 303
Waldorf, MD 20602-2513 - Phone
- (301) 645-5100
- Fax
- (301) 893-2861
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MD040202E | PA | Primary |
Addresses
Primary practice location
12070 Old Line Ctr
Suite 303
Waldorf, MD 20602-2513
Mailing address
12070 Old Line Ctr
Suite 303
Waldorf, MD 20602-2513
Phone (301) 645-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018215280005 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD040202E | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| B.S.Mahal,MD & P.K. Kulkarni, MD,PA | Past | Accepting new patients | |
| Medstar Medical Group II LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
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- NPI 1760582944
-
- General Practice Physician
- Baltimore, MD
- NPI 1184046187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363910400000",
"number": "1699746271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12070 OLD LINE CTR",
"address_2": "SUITE 303",
"city": "WALDORF",
"state": "MD",
"postal_code": "206022513",
"telephone_number": "301-645-5100",
"fax_number": "301-863-2861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12070 OLD LINE CTR",
"address_2": "SUITE 303",
"city": "WALDORF",
"state": "MD",
"postal_code": "206022513",
"telephone_number": "301-645-5100",
"fax_number": "301-893-2861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYWOOD",
"first_name": "THOMAS",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2013-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "PA",
"license": "MD040202E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018215280005",
"state": "PA"
}
],
"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 Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.