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NPI Code Detail

MEDICARE: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

MEDICARE: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician
2152W00000XOptometrist
3133N00000XNutritionist
4207K00000XAllergy & Immunology Physician
5207R00000XInternal Medicine Physician
62084P0800XPsychiatry Physician
7207X00000XOrthopaedic Surgery Physician
8103T00000XPsychologist
9207RE0101XEndocrinology, Diabetes & Metabolism Physician
10207Q00000XFamily Medicine Physician
11207RG0100XGastroenterology Physician
12207RS0012XSleep Medicine (Internal Medicine) Physician
13213E00000XPodiatrist
142085R0202XDiagnostic Radiology Physician
15302R00000XHealth Maintenance Organization

General Provider Information

NPI Number : 1730254681
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Provider Business Mailing Address
First Line : 4000 GARDEN CITY DR
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-2418
Country : US
Telephone Number : 301-816-2424
Fax Number :
Provider Business Practice Location Address
First Line : 4000 GARDEN CITY DR
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-2418
Country : US
Telephone Number : 301-816-2424
Fax Number :
Authorized Official
Title or Position : DIRECTOR, CREDENTIALING
Name : COLLEEN SWINTON
Credential :
Telephone Number : 301-257-2797
Provider Enumeration Date : 11/22/2006
Last Update Date : 04/28/2026

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