NPIMap

Organization Active NPI

Suburban Nephrology Associates LLC

  • Specialist
  • Glenn Dale, MD
National Provider Identifier
1972748192
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SUBURBAN NEPHROLOGY ASSOCIATES LLC
Practice address
12200 Annapolis Rd Ste 233
Glenn Dale, MD 20769-9182
Phone
(240) 965-7955
Fax
(301) 699-1703
NPI assigned
Dec 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Authorized official

Name
Dr. Babak Razi, MDNPI 1942345970
Title
Owner
Phone
(240) 965-7955

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD Primary

Addresses

Primary practice location

12200 Annapolis Rd Ste 233
Glenn Dale, MD 20769-9182

Mailing address

4404 Queensbury Road
Suite #100
Riverdale, MD 20737
Phone (301) 779-1949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090609000539 DC Part B Supplier - Clinic/Group Practice 3173688538 Receives reassigned benefits from 2 practitioners
Practice locations: Greenbelt, MD

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1972748192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 QUEENSBURY ROAD",
            "address_2": "SUITE #100",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "20737",
            "telephone_number": "301-779-1949",
            "fax_number": "301-699-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD STE 233",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "240-965-7955",
            "fax_number": "301-699-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN NEPHROLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "RAZI",
        "authorized_official_first_name": "BABAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-965-7955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenn Dale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.