NPIMap

Organization Active NPI

Eran Kessous MD PC

Doing business as Montgomery Sports Medicine

  • Sports Medicine (Internal Medicine) Physician
  • Gaithersburg, MD
National Provider Identifier
1922829712
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
Legal business name
ERAN KESSOUS MD PC
Doing business as
Montgomery Sports Medicine
Practice address
800 S Frederick Ave Ste 110
Gaithersburg, MD 20877-4151
Phone
(301) 754-0505
Fax
(301) 754-0509
NPI assigned
Oct 23, 2024
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ERAN KESSOUS MD PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Eran Kessous, MDNPI 1821033358
Title
Owner
Phone
(301) 754-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) Physician 207RS0010X Primary

Addresses

Primary practice location

800 S Frederick Ave Ste 110
Gaithersburg, MD 20877-4151

Mailing address

11120 New Hampshire Ave Ste 411
Silver Spring, MD 20904-2620
Phone (301) 754-0505

Other names 2

  • Montgomery Sports Medicine Doing business as
  • Eran Kessous, M.D, P.C Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Eran Kessous MD PC6 organizations share this tax ID, including this one
Part of
Eran Kessous MD PC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1922829712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE STE 411",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042620",
            "telephone_number": "301-754-0505",
            "fax_number": "301-754-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S FREDERICK AVE STE 110",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774151",
            "telephone_number": "301-754-0505",
            "fax_number": "301-754-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERAN KESSOUS MD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ERAN KESSOUS MD PC",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "KESSOUS",
        "authorized_official_first_name": "ERAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-754-0505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eran Kessous, M.D, P.C",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Oct 23, 2024; 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.