Individual provider Active NPI

Nnenna Joy Maduforo, D.O.

  • Obstetrics & Gynecology Physician
  • Alexandria, VA
National Provider Identifier
1811337025
Registry record updated Jun 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0102205042 Issued in VA
Practice address
3000 Potomac Ave
Alexandria, VA 22305-3084
Phone
(703) 721-6000
Fax
(703) 721-6721
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0102205042 VA Primary

Addresses

Primary practice location

3000 Potomac Ave
Alexandria, VA 22305-3084

Mailing address

3000 Potomac Ave
Alexandria, VA 22305-3084
Phone (703) 430-8844

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230422000066 MD Practitioner - Obstetrics/Gynecology 0345589990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calverthealth Medical Group, LLCGroup PAC ID 2163562695, 50 clinicians

Practice addresses (Care Compare)

110 Hospital Rd
Suite 203
Prince Frederick, MD 20678-4045
Phone (410) 414-4740

Merit-based Incentive Payment System (MIPS)

Final score
86.48 of 100Reported as group
Quality
74.54
Promoting interoperability
99
Improvement activities
40
Cost
81.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102205042VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Jun 25, 2024 Accepting new patients
Calverthealth Medical Group, LLC CurrentSince Aug 1, 2024 Accepting new patients
Calverthealth Medical Group, LLC Obstetrics & Gynecology Current Accepting new patients
Calverthealth Medical Group, LLC Obstetrics & Gynecology CurrentSince Aug 1, 2024 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jun 25, 2024 Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

8924 Chesapeake Ave
North Beach, MD 20714
Phone (410) 257-7279

110 Hospital Rd
Ste 310
Prnc Frederck, MD 20678
Phone (410) 414-4740

110 Hospital Rd
Ste 203
Prnc Frederck, MD 20678
Phone (410) 414-4740

Interoperability endpoints

  • Direct secure messaging: nmaduforo774764@soc.inova.org

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1811337025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 POTOMAC AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223053084",
            "telephone_number": "703-430-8844",
            "fax_number": "703-430-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 POTOMAC AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223053084",
            "telephone_number": "703-721-6000",
            "fax_number": "703-721-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADUFORO",
        "first_name": "NNENNA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0102205042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3000 Potomac Ave",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223053084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.