Individual provider Active NPI

Mitra Rangarajan, MSN, ANP-BC,

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1972745735
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R170452 Issued in MD
Practice address
1830 E Monument St Ste 426
Baltimore, MD 21287-0020
Phone
(410) 614-5388
NPI assigned
Mar 25, 2009
Last updated
May 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R170452 MD Primary

Addresses

Primary practice location

1830 E Monument St Ste 426
Baltimore, MD 21287-0020

Mailing address

1830 E Monument St Ste 426
Baltimore, MD 21287-0020
Phone (410) 614-5388

Other identifiers 1

IdentifierTypeStateIssuer
030846300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100511000427 MD Practitioner - Nurse Practitioner 7315075488 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R170452MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Jun 20, 2023 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jun 28, 2017 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Jun 28, 2017 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Jun 20, 2023 Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2411 W Belvedere Ave
Ste 305
Baltimore, MD 21215
Phone (410) 542-4700

2435 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-0900

2435 W Belvedere Ave
Ste 21
Baltimore, MD 21215
Phone (410) 601-5961

2435 W Belvedere Ave
Ste 51
Baltimore, MD 21215
Phone (410) 578-5392

2700 Quarry Lake Dr
Ste 220
Baltimore, MD 21209
Phone (410) 469-5555

8600 Liberty Rd
Randallstown, MD 21133
Phone (410) 366-5600

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1972745735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 E MONUMENT ST STE 426",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870020",
            "telephone_number": "410-614-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 E MONUMENT ST STE 426",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870020",
            "telephone_number": "410-614-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGARAJAN",
        "first_name": "MITRA",
        "credential": "MSN, ANP-BC,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R170452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030846300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.