NPIMap

Individual provider Active NPI

Kiranmayi Adimoolam, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Pasadena, MD
National Provider Identifier
1851688931
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
D87962 Issued in MD
Practice address
3708 Mountain Rd
Pasadena, MD 21122-2025
Phone
(410) 553-8273
NPI assigned
Jul 8, 2011
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10040145 TX
Geriatric Medicine (Family Medicine) Physician 207QG0300X D87962 MD Primary

Addresses

Primary practice location

3708 Mountain Rd
Pasadena, MD 21122-2025

Mailing address

900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924
Phone (443) 462-5010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191014000830 MD Practitioner - Family Practice 0749511350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7556 Teague Rd
Suite 450
Hanover, MD 21076-1968
Phone (410) 553-2900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10040145TXMDFamily Medicine Physician
D87962MDMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Medical First P.a. CurrentSince Sep 2, 2019 Accepting new patients
University of Maryland Community Medical Group, Inc. Family Medicine CurrentSince Sep 28, 2020 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 28, 2020 Accepting new patients

Locations

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

219 S Washington St
Easton, MD 21601

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

7556 Teague Rd
Ste 450
Hanover, MD 21076
Phone (410) 553-2900

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

8901 Clement Ave
Parkville, MD 21234
Phone (410) 661-4670

3708 Mountain Rd
Pasadena, MD 21122
Phone (410) 255-1600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAFGCA
  • Direct secure messaging: kadimoolam692832@direct.umm.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1851688931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ELKRIDGE LANDING RD FL 2",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902924",
            "telephone_number": "443-462-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 MOUNTAIN RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211222025",
            "telephone_number": "410-553-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADIMOOLAM",
        "first_name": "KIRANMAYI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10040145",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D87962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

Verify at the official NPI Registry.