Individual provider Active NPI

Robert Konkol, M.D.

  • Child & Adolescent Psychiatry Physician
  • Leonardtown, MD
National Provider Identifier
1790784890
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
D21021 Issued in MD
Practice address
25500 Point Lookout Rd
St. Mary'S Hospital
Leonardtown, MD 20650-0527
Phone
(301) 475-6227
Fax
(301) 475-6169
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D21021 MD
Child & Adolescent Psychiatry Physician 2084P0804X D21021 MD Primary

Addresses

Primary practice location

25500 Point Lookout Rd
St. Mary'S Hospital
Leonardtown, MD 20650-0527

Mailing address

1911 Watson Rd
Owings, MD 20736-9720
Phone (410) 257-9084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D21021MDMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Vision Care Ophthalmic Dispensing LLC PastSince Mar 30, 2012 Accepting new patients

Organizations & group practices 1

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1790784890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 WATSON RD",
            "city": "OWINGS",
            "state": "MD",
            "postal_code": "207369720",
            "telephone_number": "410-257-9084",
            "fax_number": "301-475-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 POINT LOOKOUT RD",
            "address_2": "ST. MARY'S HOSPITAL",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206500527",
            "telephone_number": "301-475-6227",
            "fax_number": "301-475-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONKOL",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D21021",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D21021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.