NPIMap

Organization Active NPI

Ajit P Kuruvilla MD LLC

  • Pulmonary Disease Physician
  • Rockville, MD
National Provider Identifier
1801131024
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
AJIT P KURUVILLA MD LLC
Practice address
2401 Research Blvd
Suite 350
Rockville, MD 20850-3215
Phone
(301) 758-9697
Fax
(301) 668-5233
NPI assigned
Nov 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Authorized official

Name
Dr. Ajit P Kuruvilla, MDNPI 1568487247
Title
Ceo
Phone
(301) 758-9697

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X MD
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X MD Primary

Addresses

Primary practice location

2401 Research Blvd
Suite 350
Rockville, MD 20850-3215

Mailing address

8129 Huntfield Dr
Fulton, MD 20759-2104
Phone (301) 758-9697

Other identifiers 1

IdentifierTypeStateIssuer
214050100MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150302001550 DC Part B Supplier - Clinic/Group Practice 8729304118 Receives reassigned benefits from 4 practitioners
Practice locations: Rockville, MD

National Provider Directory

National Provider Directory
Tax ID family
Ajit P Kuruvilla MD LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1801131024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8129 HUNTFIELD DR",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592104",
            "telephone_number": "301-758-9697",
            "fax_number": "301-668-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RESEARCH BLVD",
            "address_2": "SUITE 350",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503215",
            "telephone_number": "301-758-9697",
            "fax_number": "301-668-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJIT P KURUVILLA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "KURUVILLA",
        "authorized_official_first_name": "AJIT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-758-9697",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214050100",
            "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 Mar 6, 2017; 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.