ROZA MEDICAL CENTER, LLC
NPI 1023795945
Nurse Practitioner in Gaithersburg, MD

Active since July 03, 2023CLIA 21D2317299 · Waiver
941 RUSSELL AVE STE B, GAITHERSBURG, MD 20879(240) 848-7692 Get Directions Write a Review

NPPES record last updated: March 22, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 22, 2025, Nov 11, 2024, Jul 3, 2023 (3 updates tracked since 2023).

About Roza Medical Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROZA MEDICAL CENTER, LLC (NPI 1023795945) is a healthcare organization registered as a nurse practitioner in Gaithersburg, Maryland and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through January 21, 2027 and lists Bulat Khamitov, Ceo, as its authorized official.

NPPES Registry Identity

NPI1023795945
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameROZA MEDICAL CENTER, LLC
Location Address941 RUSSELL AVE STE BGaithersburg, MD 20879-6206
Mailing Address941 Russell Ave Ste BGaithersburg, MD 20879-6206
Organization SubpartNo
Authorized OfficialBulat KhamitovCeo · (240) 848-7692
Enumeration DateJuly 3, 2023
Last NPPES UpdateMarch 22, 20253 updates tracked since enumeration
NPPES CertifiedMarch 22, 2025
NPI 1023795945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
941 RUSSELL AVE STE B, Gaithersburg, MD 20879

Other Names 1

Former Legal Business NameRoza Medical Center, Llc

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2317299

Roza Medical Center · Gaithersburg, MD
Active · expires Jan 21, 2027
CLIA Number21D2317299
Laboratory TypePractitioner Other
Certificate Effective DateJanuary 22, 2025
Certificate Expiration DateJanuary 21, 2027
Laboratory DirectorRoza N. Liss
Laboratory Phone(240) 848-7692
Laboratory LocationRoza Medical Center941 Russell Ave #b, Gaithersburg, MD 20879
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Primary Care)
941 RUSSELL AVE STE B
GAITHERSBURG, MD 20879
Dentist (General Practice)
941 RUSSELL AVE STE B
GAITHERSBURG, MD 20879

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 Roza Medical Center, LLC's NPI number?

The NPI number for Roza Medical Center, LLC is 1023795945. It was assigned to this organization in the NPPES registry on July 3, 2023.

Where is Roza Medical Center, LLC located?

Roza Medical Center, LLC is located at 941 Russell Ave Ste B, Gaithersburg, MD 20879. The listed phone number is (240) 848-7692.

What is Roza Medical Center, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Roza Medical Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2317299) is associated with this NPI, valid through January 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Roza Medical Center, LLC was last updated on March 22, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.