Active NPI
James M Kiwanuka, M.D.
- Pediatrics Physician
- Gaithersburg, MD
National Provider Identifier
1811951049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0027070
- Practice address
- 935 Russell Ave
Gaithersburg, MD 20879-3291 - Phone
- (301) 926-7891
- Fax
- (301) 926-7892
- NPI assigned
- Apr 14, 2006
- Last updated
- Sep 14, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0027070 | MD | Primary |
Addresses
Primary practice location
935 Russell Ave
Gaithersburg, MD 20879-3291
Mailing address
14302 Trillium Ter
Silver Spring, MD 20906-2457
Phone (301) 603-1884
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1200792 | Other | MD | UNITED HEALTHCARE |
| 644721000 | Medicaid | MD | |
| 4303JM | Other | MD | BLUE CROSS BLUE SHEILD MD |
| 41835 | Other | MD | AETNA |
| 04021 | Other | MD | AMERIGROUP MCO |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0027070 | MD | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Contee Emergency Physicians | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Laurel, MD
- NPI 1710936398
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1811951049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14302 TRILLIUM TER",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209062457",
"telephone_number": "301-603-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 RUSSELL AVE",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793291",
"telephone_number": "301-926-7891",
"fax_number": "301-926-7892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIWANUKA",
"first_name": "JAMES",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0027070",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1200792",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "644721000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD MD",
"identifier": "4303JM",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "41835",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP MCO",
"identifier": "04021",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.