| Mruthyunjaya Gonchigar, MD | |
|
196 Thomas Johnson Dr, Suite 215, Frederick, MD 21702-4397 | |
| (301) 668-9988 | |
| (301) 668-9977 |
| Full Name | Mruthyunjaya Gonchigar |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 42 Years |
| Location | 196 Thomas Johnson Dr, Frederick, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043275449 | NPI | - | NPPES |
| P00875961 | Other | MD | MEDICARE RAILROAD |
| 697L395D | Other | MD | PAIN MANAGEMENT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208VP0000X | Pain Medicine - Pain Medicine | D0050726 (Maryland) | Primary |
| 207L00000X | Anesthesiology | D0050726 (Maryland) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Privia Medical Group, Llc | 4385682061 | 1264 |
| Entity Name | Newbridge Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891931556 PECOS PAC ID: 6103971759 Enrollment ID: O20090902000622 |
| Entity Name | Newbridge Spine And Pain Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790921450 PECOS PAC ID: 7113073024 Enrollment ID: O20090917000613 |
| Entity Name | Newbridge Surgery Center At Frederick |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1508199720 PECOS PAC ID: 6204979172 Enrollment ID: O20100202000087 |
| Entity Name | Newbridge Surgery Center At Prince Frederick, Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1285944504 PECOS PAC ID: 0244413607 Enrollment ID: O20110322000585 |
| Entity Name | Privia Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20140522000040 |
| Mailing Address | Practice Location Address |
|---|---|
| Mruthyunjaya Gonchigar, MD 196 Thomas Johnson Dr, Suite 215, Frederick, MD 21702-4397 Ph: (301) 668-9988 | Mruthyunjaya Gonchigar, MD 196 Thomas Johnson Dr, Suite 215, Frederick, MD 21702-4397 Ph: (301) 668-9988 |