NPIMap

Organization Active NPI

Montgomery Physician Associates PC

  • Internal Medicine Physician
  • Montgomery Village, MD
National Provider Identifier
1801989942
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0040860 Issued in MD
Legal business name
MONTGOMERY PHYSICIAN ASSOCIATES PC
Practice address
19241 Montgomery Village Avenue
Ste E23
Montgomery Village, MD 20886-5036
Phone
(301) 948-0098
Fax
(301) 926-9180
NPI assigned
Oct 2, 2006
Last updated
Sep 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Authorized official

Name
Dr. Anoma Bandara, MDNPI 1043303183
Title
President Physician
Phone
(301) 948-0098

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0031720 MD
Internal Medicine Physician 207R00000X D0040860 MD Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X D0031720 MD

Addresses

Primary practice location

19241 Montgomery Village Avenue
Ste E23
Montgomery Village, MD 20886-5036

Mailing address

19241 Montgomery Village Avenue
Ste E23
Montgomery Village, MD 20886-5036
Phone (301) 948-0098

Other identifiers 1

IdentifierTypeStateIssuer
201502100MedicaidMD

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1801989942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19241 MONTGOMERY VILLAGE AVENUE",
            "address_2": "STE E23",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208865036",
            "telephone_number": "301-948-0098",
            "fax_number": "301-926-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19241 MONTGOMERY VILLAGE AVENUE",
            "address_2": "STE E23",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208865036",
            "telephone_number": "301-948-0098",
            "fax_number": "301-926-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY PHYSICIAN ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "BANDARA",
        "authorized_official_first_name": "ANOMA",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "301-948-0098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0031720",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0040860",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "D0031720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201502100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery Village, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.