Mahesh Moondra, MD, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D32014 Issued in MD

Legal business name

MAHESH MOONDRA, MD, PA

Practice address

106 Milford St
Suite 504B
Salisbury, MD 21804-6953

Phone

(410) 546-5954

Fax

(410) 219-3038

NPI assigned

Jul 7, 2005

Last updated

Mar 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mahesh Moondra, MDNPI 1912932237

Title

Owner

Phone

(410) 546-5954

Specialties & licenses 1

Addresses

Other identifiers 15

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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.

• Mahesh Moondra, M.D.

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1912932237
  Medicare reassignment Authorized official
• Babulal Das, MD

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1427055250
  Medicare reassignment
• Vel Natesan, M.D.

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1457372310
  NPD (past)
• Mary Anne Walker, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Salisbury, MD
  • NPI 1699761619
  NPD (past)
• Jane E Anderson, NP

  • Family Nurse Practitioner
  • Troy, VA
  • NPI 1700099389
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1861499634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE 504B",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-546-5954",
            "fax_number": "410-219-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE 504B",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-546-5954",
            "fax_number": "410-219-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHESH MOONDRA, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "MOONDRA",
        "authorized_official_first_name": "MAHESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-546-5954",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D32014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PP",
            "identifier": "30773",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSVA",
            "identifier": "251300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USHC",
            "identifier": "510427",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MADE",
            "identifier": "0000875602",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBRR",
            "identifier": "110140803",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETN",
            "identifier": "4393240",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "000799857",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMD",
            "identifier": "545418200",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "545418200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSDC",
            "identifier": "E475",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "21728011",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHP",
            "identifier": "32014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMS",
            "identifier": "843455",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "191308",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSMD",
            "identifier": "KA67MA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.