Joseph R Tiralla, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

D0020619 Issued in MD

Practice address

110 Hospital Rd
Suite #202
Prince Frederick, MD 20678-4019

Phone

(410) 257-3150

Fax

(410) 535-3912

NPI assigned

Mar 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Calvert OBGYN Associates of Southern Maryland, LLC

  • Obstetrics & Gynecology Physician
  • Prince Frederick, MD
  • NPI 1104940139
  Authorized official Same address or phone

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710019559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD",
            "address_2": "SUITE #211",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784019",
            "telephone_number": "410-257-3150",
            "fax_number": "410-535-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD",
            "address_2": "SUITE #202",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784019",
            "telephone_number": "410-257-3150",
            "fax_number": "410-535-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRALLA",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0020619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI UNITED HEALTH CARE",
            "identifier": "366483",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD DC",
            "identifier": "6906-0002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "2217645",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MARYLAND",
            "identifier": "366030-03",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Witmer Thir, PSY.D
• Reena Mary Thomas, M.D.
• Jenna Thompson, LCSW-C
• Tidewater Dental PF
• Tidewater LLC
• Meghan Duncan Toffey, LCSW-C
• Transitions Counseling, LLC
• David Trimble, MD
• Theresa Marie Troescher Snell, BA, CSC-ADP
• Rebecca Trott, LCSW-C

• Obstetrics & Gynecology Physician in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Obstetrics & Gynecology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.