PREMIER MEDICAL GROUP OF MARYLAND LLC
NPI 1023791605
Clinic/Center - Primary Care in Columbia, MD
About Premier Medical Group Of Maryland Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMIER MEDICAL GROUP OF MARYLAND LLC (NPI 1023791605) is a healthcare organization registered as a primary care in Columbia, Maryland and active in the NPI registry since August 2023. The organization lists Mary Fakorede, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Premier Medical Group Of Maryland Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Premier Medical Group Of Maryland LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Premier Medical Group Of Maryland LLC's NPI number?
The NPI number for Premier Medical Group Of Maryland LLC is 1023791605. It was assigned to this organization in the NPPES registry on August 9, 2023.
Where is Premier Medical Group Of Maryland LLC located?
Premier Medical Group Of Maryland LLC is located at 10705 Charter Dr Ste 350, Columbia, MD 21044. The listed phone number is (410) 709-7432.
What is Premier Medical Group Of Maryland LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Premier Medical Group Of Maryland LLC enrolled in Medicare?
Yes. Premier Medical Group Of Maryland LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Premier Medical Group Of Maryland LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Premier Medical Group Of Maryland LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Premier Medical Group Of Maryland LLC was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Premier Medical Group Of Maryland Llc · NPI 1023791605
Primary Care organization in Columbia, Maryland. Organization record, active in the CMS NPPES registry since August 9, 2023.
## Identity
- **NPI:** 1023791605 (Entity type: Organization)
- **Enumerated:** August 9, 2023
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Mary Fakorede, MD
## Practice location
- **Address:** 10705 CHARTER DR STE 350, Columbia, MD 21044-2995
- **Phone:** (410) 709-7432
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 23, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1023791605) · Data from the CMS NPPES public registry.