Organization Active NPI

The Physicians Group Chartered

  • General Practice Physician
  • Waldorf, MD
National Provider Identifier
1881780211
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
H0042445 Issued in MD
Legal business name
THE PHYSICIANS GROUP CHARTERED
Practice address
601 Post Office Rd
Suite 1-a
Waldorf, MD 20602-1912
Phone
(301) 638-0186
Fax
(301) 843-6857
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Authorized official

Name
Dr. Michael Anthony Pimentel, DO
Title
Treasurer
Phone
(301) 638-0186

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X D0038147 MD
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X H0042445 MD
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X H0048020 MD
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X H0042445 MD Primary

Addresses

Primary practice location

601 Post Office Rd
Suite 1-a
Waldorf, MD 20602-1912

Mailing address

601 Post Office Rd
Suite 1-a
Waldorf, MD 20602-1912
Phone (301) 638-0186

Other identifiers 1

IdentifierTypeStateIssuer
203631200MedicaidMD

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1881780211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 POST OFFICE RD",
            "address_2": "SUITE 1-A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021912",
            "telephone_number": "301-638-0186",
            "fax_number": "301-843-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 POST OFFICE RD",
            "address_2": "SUITE 1-A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021912",
            "telephone_number": "301-638-0186",
            "fax_number": "301-843-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHYSICIANS GROUP CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "PIMENTEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "301-638-0186",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0038147",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H0042445",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "H0048020",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MD",
            "license": "H0042445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203631200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.

Verify at the official NPI Registry.