NPIMap

Organization Active NPI

M Medical Group, Inc.

  • Internal Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1710793906
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
M MEDICAL GROUP, INC.
Practice address
7355 E Furnace Branch Rd
Glen Burnie, MD 21060-7060
Phone
(410) 766-3460
NPI assigned
Dec 3, 2024
Last updated
Dec 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Krystle D Brown
Title
Billing Manager
Phone
(410) 800-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

7355 E Furnace Branch Rd
Glen Burnie, MD 21060-7060

Mailing address

7355 E Furnace Branch Rd
Glen Burnie, MD 21060-7060
Phone (410) 766-3460

Other names 1

  • Autumn Lake Glen Burnie Health and Rehab Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200902001506 MD Part B Supplier - Clinic/Group Practice 7719278597 Receives reassigned benefits from 98 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Annapolis, MD; Towson, MD; Rising Sun, MD; Pikesville, MD; Lutherville, MD; Hagerstown, MD; Glen Burnie, MD; Frederick, MD…

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
M Medical Group Inc62 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, 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": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1710793906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 E FURNACE BRANCH RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210607060",
            "telephone_number": "410-766-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 E FURNACE BRANCH RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210607060",
            "telephone_number": "410-766-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KRYSTLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "410-800-6251"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Glen Burnie Health and Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.