Individual provider Active NPI

Kathryn Maduforo, NP

  • Family Nurse Practitioner
  • Silver Spring, MD
National Provider Identifier
1750946729
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R202144 Issued in MD
Practice address
11223 Lockwood Dr
Silver Spring, MD 20901-4554
Phone
(240) 254-3375
Fax
(410) 844-6442
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R202144 MD Primary

Addresses

Primary practice location

11223 Lockwood Dr
Silver Spring, MD 20901-4554

Mailing address

11223 Lockwood Dr
Silver Spring, MD 20901-4554
Phone (240) 254-3375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200327000235 DC Practitioner - Nurse Practitioner 7618306697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11223 Lockwood Dr
Silver Spring, MD 20901-4554
Phone (240) 254-3375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rehoboth Medical Center LLC Clinic/Center CurrentSince Jan 1, 2020 Accepting new patients
Rehoboth Group LLC Current Accepting new patients

Locations

11223 Lockwood Dr
Silver Spring, MD 20901
Phone (240) 254-3375

14446 Layhill Rd
Silver Spring, MD 20906
Phone (240) 606-7031

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.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1750946729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11223 LOCKWOOD DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014554",
            "telephone_number": "240-254-3375",
            "fax_number": "410-844-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11223 LOCKWOOD DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014554",
            "telephone_number": "240-254-3375",
            "fax_number": "410-844-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADUFORO",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R202144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.