Individual provider Active NPI

Angela M Tamayo, M.D.

  • Pediatrics Physician
  • Columbia, MD
National Provider Identifier
1982627964
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D52295 Issued in MD
Practice address
7070 Samuel Morse Dr
Kaiser Permanente Medical Center
Columbia, MD 21046-3424
Phone
(410) 309-4646
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D52295 MD Primary

Addresses

Primary practice location

7070 Samuel Morse Dr
Kaiser Permanente Medical Center
Columbia, MD 21046-3424

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicareenrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Other identifiers 3

IdentifierTypeStateIssuer
KJ50GB/54720303OtherMDCAREFIRST MARYLAND
S139/0020OtherMDCAREFIRST REGIONAL
467550900MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000641 MD Practitioner - Pediatric Medicine 9234318569 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 27, 2010 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 27, 2010 Accepting new patients
Baltimore Washington Medical Center Inc. Past Accepting new patients
Luminis Health Anne Arundel Medical Center, Inc. Past Accepting new patients
University of Maryland St. Joseph Medical Center, LLC Past Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
#6
Rockville, MD 20852

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1982627964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICAREENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7070 SAMUEL MORSE DR",
            "address_2": "KAISER PERMANENTE MEDICAL CENTER",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463424",
            "telephone_number": "410-309-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAYO",
        "first_name": "ANGELA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D52295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARYLAND",
            "identifier": "KJ50GB/54720303",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "S139/0020",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "467550900",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "7070 Samuel Morse Dr",
            "address_2": "Kaiser Permanente Medical Center",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210463424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.