Individual provider Active NPI

Samantha Maldonado

  • Registered Dietitian
  • Greenbelt, MD
National Provider Identifier
1760195101
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX5915 Issued in MD
Practice address
6301 Ivy LN Ste 410
Greenbelt, MD 20770-6357
Phone
(301) 474-2499
NPI assigned
Dec 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DX5915 MD Primary

Addresses

Primary practice location

6301 Ivy LN Ste 410
Greenbelt, MD 20770-6357

Mailing address

6301 Ivy LN Ste 410
Greenbelt, MD 20770-6357
Phone (301) 474-2499

Other practice location 1

189 Lantana Rd
Crossville, TN 38555-5078
Phone (931) 456-0881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230711002658 DC Practitioner - Registered Dietitian Or Nutrition Professional 8628437464 Reassigns benefits to 1 organization
I20250730002759 TN Practitioner - Registered Dietitian Or Nutrition Professional 8628437464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

933 W Race St
Kingston, TN 37763-2123
Phone 865882010586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DX5915MDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Jul 1, 2025 Accepting new patients
Rebecca Bitzer Ms Rd & Associates Inc Dietitian, Registered CurrentSince May 28, 2023 Accepting new patients
Summit Medical Group, PLLC CurrentSince Jul 1, 2025 Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients
Summit Medical Group,PLLC PastSince Jan 26, 2025 Accepting new patients

Locations

6301 Ivy Ln
Ste 410
Greenbelt, MD 20770
Phone (301) 474-2499

1607 Westgate Cir
Ste 200
Brentwood, TN 37027
Phone (615) 376-8195

109 Del Rio Pike
Franklin, TN 37064
Phone (615) 432-3854

380 W Broadway Blvd
Jefferson City, TN 37760
Phone (865) 450-9361

933 W Race St
Kingston, TN 37763
Phone (865) 882-0105

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909

Interoperability endpoints

  • Direct secure messaging: samantha.maldonado.1@20785.direct.athenahealth.com

Organizations & group practices 5

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": "1672358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1760195101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 IVY LN STE 410",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207706357",
            "telephone_number": "301-474-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 IVY LN STE 410",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207706357",
            "telephone_number": "301-474-2499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "189 Lantana Rd",
            "address_purpose": "LOCATION",
            "city": "Crossville",
            "state": "TN",
            "postal_code": "385555078",
            "country_code": "US",
            "telephone_number": "931-456-0881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-30",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX5915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.