KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC (NPI# 1558639286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558639286 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC |
| Other Organization Name | KAISER PERMANENTE GAITHERSBURG INFUSION PHARMACY |
| Practice Address |
655 Watkins Mill Rd Gaithersburg MD 20879-3323 |
| Mailing Address |
22370 Davis Dr Suite 190 Sterling VA 20164-5366 |
| Practice Telephone | 2406324565 |
| Practice Fax Number | 2406324566 |
| Mailing Telephone | 7034664800 |
| Mailing Fax Number | 7034664802 |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2013-12-23 |
| Authorized Official Name | MS. ANDEE G PETERSEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3018165760 |
| 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 | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | MEDICARE GROUP ID | 410092 | 01 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Gaithersburg Infusion Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265971873 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Health Maintenance Organization | 3400 Box Hill Corporate Center Dr, Stes 100 & 200, Abingdon, MD 21009-9998 | 2017-02-15 |
| 1043378656 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Psychologist | 10 Hopkins Plaza, Baltimore, MD 21201-2902 | 2006-12-05 |
| 1740355684 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 815 E Pratt St, Baltimore, MD 21202-4402 | 2006-11-22 |
| 1902971849 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 1396 Piccard Drive, Rockville, MD 20850-4302 | 2006-11-22 |
| 1497820435 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 6501 Loisdale Road, Springfield, VA 22150-1845 | 2006-11-22 |
| 1013082957 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 8028 Richie Highway, Pasadena, MD 21222-1030 | 2006-11-22 |
| 1346315280 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 4920 Campbell Boulevard, Baltimore, MD 21236-5916 | 2006-11-22 |
| 1003981945 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 7070 Samuel Morse Drive, Columbia, MD 21046-3405 | 2006-11-22 |
| 1720153661 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 12201 Plum Orchard Drive, Silver Spring, MD 20910-7803 | 2006-11-22 |
| 1033658521 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 7670 Quarterfield Rd, Glen Burnie, MD 21061-3947 | 2017-02-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 1 Kaiser Plz, Oakland, CA 94612-3610 |
| Street Address |
655 WATKINS MILL RD |
| City | GAITHERSBURG |
| State | MD |
| Zip Code | 20879-3323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629048467 | Julie May Chen | Internal Medicine | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2006-01-24 |
| 1376142315 | Helen Gebereselassie Gamada | Nurse Practitioner | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2020-10-21 |
| 1043848526 | Scott Eric Jackson | Radiologic Technologist | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2020-03-30 |
| 1972130524 | Huai En Chang | Student in an Organized Health Care Education/Training Program | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2020-03-24 |
| 1477189322 | Sushmita Malik | Student in an Organized Health Care Education/Training Program | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2020-03-22 |
| 1316573314 | Crystal Xue | Student in an Organized Health Care Education/Training Program | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2020-03-21 |
| 1144856287 | Daniel Tadeo | Student in an Organized Health Care Education/Training Program | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2020-03-20 |
| 1659902963 | Susan Marie Jagt | Radiology | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2020-01-27 |
| 1295373371 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2019-12-19 |
| 1497306971 | Claudia Priscilla Derse-anthony | Registered Nurse | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3301 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565688 | Mark Schulze | Behavior Technician | 20620 Prathertown Rd., Gaithersburg, MD 20879 | 2020-10-12 |
| 1497242705 | Ajena Callaway | Occupational Therapist | 354 A Christopher Avenue, Gaithersburg, MD 20879 | 2018-04-23 |
| 1952702789 | Alan Huang | Physical Therapist | 18603 Tribble Way, Gaithersburg, MD 20879 | 2014-09-11 |
| 1225452089 | Benefitcare Inc. | Home Health | 18211d Flower Hill Way, Gaithersburg, MD 20879 | 2014-02-13 |
| 1578832739 | Thomas Yoon | Dentist | 20219 Goshen Rd, Gaithersburg, MD 20879 | 2011-12-17 |
| 1962637090 | Team Care, LLC | Non-emergency Medical Transport (VAN) | 8041 Cessna Avenue, Suite 200, Gaithersburg, MD 20879 | 2009-05-19 |
| 1730327412 | Maryland Home Health, LLC | Home Health | 2 Professional Drive, Suite 241, Gaithersburg, MD 20879 | 2009-02-03 |
| 1528223740 | Behzad Mirdamadi | Dentist | 18218 Flower Hill Way, Dental Suite Habibi and Mirdamadi, D.d.s., P.a., Gaithersburg, MD 20879 | 2008-07-28 |
| 1265696322 | Nargess Mirhakkak Biparva | Dentist | 941 B Russell Ave, Gaithersburg, MD 20879 | 2008-07-17 |
| 1891818639 | Carolyn June Figard | Counselor | 933 Russess Ave., Suite D, Gaithersburg, MD 20879 | 2007-04-09 |
| Find all providers in zip 20879 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568407914 | Ald Enterprises, LLC | Pharmacy | 1520 Caton Center Dr, Suite S, Baltimore, MD 21227-1554 | 2006-06-19 |
| 1760455059 | Maryland Respiratory Group Inc | Pharmacy | 5711 Industry Ln, Suite 33, Frederick, MD 21704-8211 | 2006-02-08 |
| 1497759443 | Apple Infusion Inc | Pharmacy | 404b N Fruitland Blvd, Salisbury, MD 21801-7261 | 2005-06-08 |
| 1538585773 | Maryland Pharmacy and Home Infusion, Inc | Pharmacy | 10085 Red Run Blvd, Suite 104 B, Owings Mills, MD 21117-4836 | 2014-03-12 |
| 1245576263 | Iv Solutions LLC | Pharmacy | 10231 Old Ocean City Blvd, Suite 209, Berlin, MD 21811-3566 | 2012-12-19 |
| 1649323544 | Cais, Inc | Pharmacy | 3 Commerce Dr, Cumberland, MD 21502-1092 | 2007-01-22 |
| 1275697930 | Antietam Health Services, Inc | Pharmacy | 11110 Medical Campus Rd, Suite 105, Hagerstown, MD 21742-6700 | 2006-12-20 |
| 1275606162 | Johns Hopkins Pediatrics At Home, Inc. | Pharmacy | 5901 Holabird Avenue, Suite A, Baltimore, MD 21224-6015 | 2006-11-16 |
| City | GAITHERSBURG |
| Zip Code | 20879 |
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.