Organization Active NPI

Nelson Gustavo Neder Kalil, M.D.

  • Hematology & Oncology Physician
  • Rockville, MD
National Provider Identifier
1750569802
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
D0051616 Issued in MD
Legal business name
NELSON GUSTAVO NEDER KALIL, M.D.
Practice address
6000 Executive Blvd Ste 620
Rockville, MD 20852
Phone
(240) 467-5888
Fax
(301) 348-8983
NPI assigned
Jan 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Authorized official

Name
Nelson Gustavo Neder Kalil, MDNPI 1427074707
Title
President
Phone
(240) 467-5888

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X D0051616 MD Primary

Addresses

Primary practice location

6000 Executive Blvd Ste 620
Rockville, MD 20852

Mailing address

6000 Executive Blvd Ste 620
Rockville, MD 20852-3876
Phone (240) 467-5888

Other identifiers 1

IdentifierTypeStateIssuer
694501500MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060206000435 DC Part B Supplier - Clinic/Group Practice 6709890130 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1750569802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 EXECUTIVE BLVD STE 620",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523876",
            "telephone_number": "240-467-5888",
            "fax_number": "301-348-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 EXECUTIVE BLVD STE 620",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "240-467-5888",
            "fax_number": "301-348-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON GUSTAVO NEDER KALIL, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "KALIL",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "GUSTAVO NEDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-467-5888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MD",
            "license": "D0051616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "694501500",
            "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 Sep 6, 2018; 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.