Individual provider Active NPI

Sujoy G Tagore, MD

  • Internal Medicine Physician
  • Rockville, MD
National Provider Identifier
1972796084
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0066304 Issued in MD
Practice address
15225 Shady Grove Rd
Suite 102
Rockville, MD 20850-3254
Phone
(301) 330-0661
Fax
(301) 977-6940
NPI assigned
Aug 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0066304 MD Primary

Addresses

Primary practice location

15225 Shady Grove Rd
Suite 102
Rockville, MD 20850-3254

Mailing address

15225 Shady Grove Rd
Suite 102
Rockville, MD 20850-3254
Phone (301) 330-0661

Other identifiers 1

IdentifierTypeStateIssuer
415096100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071011000131 DC Practitioner - Internal Medicine 8628164357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Plotsky Medical Associates PCGroup PAC ID 0840375069, 4 clinicians
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians

Practice addresses (Care Compare)

15225 Shady Grove Rd
Suite 102
Rockville, MD 20850-3281
Phone (301) 330-0661

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.13 of 100Reported as apm
Quality
90.26
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0066304MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plotsky Medical Associates PC Internal Medicine CurrentSince Apr 26, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Premier Physician Group, LLC Internal Medicine Past Accepting new patients
Inpatient Specialists PA Internal Medicine Past Accepting new patients

Locations

15225 Shady Grove Rd
Ste 102
Rockville, MD 20850
Phone (301) 330-0661

15225 Shady Grove Rd
Rockville, MD 20850
Phone (301) 330-0661

Interoperability endpoints

  • Direct secure messaging: plotskymedical.sujoytagore@127521.advancedmd-direct.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1972796084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD",
            "address_2": "SUITE 102",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503254",
            "telephone_number": "301-330-0661",
            "fax_number": "301-977-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD",
            "address_2": "SUITE 102",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503254",
            "telephone_number": "301-330-0661",
            "fax_number": "301-977-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGORE",
        "first_name": "SUJOY",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0066304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415096100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.