Cardiovascular Specialists of Frederick, LLC
Organization Active NPI Specialist · Frederick, MD
NPI 1922034461 · NPPES record last updated Jan 21, 2025
Key facts
- NPI
- 1922034461
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- CARDIOVASCULAR SPECIALISTS OF FREDERICK, LLC
- Practice address
- 180 Thomas Johnson Dr
202
Frederick, MD 21702-4409 - Phone
- (301) 631-6877
- Fax
- (301) 631-5211
- NPI assigned
- Jun 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Debbie K Klauka, MBA
- Title
- Practice Administrator
- Phone
- (301) 631-6877
Practitioners 17
-
Alyssa Best, CRNP
-
Amanda Diane Kallas, CRNP
-
Aimee S Park, M.D.
-
Katey Purgason, NP
-
Edward P Riuli, M.D.
-
Maya Jean Salameh, M.D.
-
Nirmal K Shah, M.D.
-
Sunil Sinha, M.D.
-
Margaret Mary Resh, PA-C
-
Stacy Bartolich, CRNP
-
Jonathan David Gardner, M.D.
-
Archana Sodagam, M.D.
-
Anne Burdeshaw Shrout, M.D.
-
Cara Cardinale Simmonds, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050222000655 | MD | Part B Supplier - Clinic/Group Practice | 4082667761 |
Receives reassigned benefits from 15 practitioners Practice locations: Frederick, MD |
National Provider Directory
Locations
184 Thomas Johnson Dr
Ste 204
Frederick, MD 21702
Phone (301) 620-7144
180 Thomas Johnson Dr
Ste 202
Frederick, MD 21702
Phone (301) 631-6877
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
180 Thomas Johnson Dr
202
Frederick, MD 21702-4409
Mailing address
180 Thomas Johnson Dr
202
Frederick, MD 21702-4409
Phone (301) 631-6877
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 217101500 | Medicaid | MD |
Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.