KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC (NPI# 1154622900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154622900 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC |
| Other Organization Name | KAISER PERMANENTE CAPITOL HILL DIALYSIS |
| Practice Address |
700 2nd St Ne Washington DC 20002-4308 |
| Mailing Address |
2101e Jefferson St 2 East Kaiser Permanente Attn:sanjay Mathur Rockville MD 20850-4908 |
| Practice Telephone | 2029895100 |
| Practice Fax Number | 3018167170 |
| Mailing Telephone | 3018167446 |
| Mailing Fax Number | 3018167170 |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2012-03-15 |
| Authorized Official Name | MR. WILLIAM G MORAN (SENOR BUSINESS &TECHNOLOGY CONSULT) |
| Authorized Official Telephone | 3018165832 |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | MEDICARE GROUP ID | 410092 | 01 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Capitol Hill Dialysis | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033578364 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc | Clinic/Center | 7141 Security Blvd, Baltimore, MD 21244-1811 | 2016-02-15 |
| 1770886681 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc | Health Maintenance Organization | 10500 Summit Ave, Kensington, MD 20895-2422 | 2010-12-15 |
| 1699084046 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc | Pharmacy | 700 2nd St Ne, Suite L18, Washington, DC 20002-4308 | 2010-10-04 |
| Street Address |
700 2ND ST NE |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20002-4308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114996 | Piyapong Vongkovit | Internal Medicine | 700 2nd St Ne, Washington, DC 20002-8100 | 2005-06-16 |
| 1225640907 | Hycenta Ndosoh Halle | Registered Nurse | 700 2nd St Ne, Washington, DC 20002-8100 | 2020-08-23 |
| 1568083822 | Michelle Yeung | Pharmacy Technician | 700 2nd St Ne, Washington, DC 20002-8100 | 2020-04-28 |
| 1285253138 | Seth A Keating | Pharmacy Technician | 700 2nd St Ne, Washington, DC 20002-8100 | 2020-04-10 |
| 1982231460 | Kiana Deneen Mack | Pharmacy Technician | 700 2nd St Ne, Washington, DC 20002-8100 | 2020-03-25 |
| 1285272369 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 700 2nd St Ne, Washington, DC 20002-8100 | 2019-12-19 |
| 1033693767 | Jewell J Reddick | Pharmacist | 700 2nd St Ne, Washington, DC 20002-8100 | 2018-09-19 |
| 1720594997 | Nathan Redington | Physical Therapist | 700 2nd St Ne, Washington, DC 20002-8100 | 2017-12-23 |
| 1558875765 | Sheryl Lynn Canlas | Pharmacist | 700 2nd St Ne, Washington, DC 20002-8100 | 2017-11-27 |
| 1114456092 | Jacinda Thieu-tran Tran | Pharmacist | 700 2nd St Ne, Washington, DC 20002-8100 | 2017-06-05 |
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| Taxonomy Code | 332BD1200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Dialysis Equipment & Supplies |
| Definition to come... |
| City | WASHINGTON |
| Zip Code | 20002 |
Please comment or provide details below to improve the information on KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.