ENNOBLE HC DMV LLC
NPI 1104492115
Family Medicine - Geriatric Medicine in Fulton, MD
About Ennoble Hc Dmv Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ENNOBLE HC DMV LLC (NPI 1104492115) is a healthcare organization registered as a geriatric medicine in Fulton, Maryland and active in the NPI registry since June 2021. The organization lists Kush Das, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ennoble Hc Dmv Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
149Medicare enrollment records show 149 clinicians reassign Medicare billing to Ennoble Hc Dmv LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 6
Nearest to this location (20)
See all 149Linthicum Heights, MD 21090
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 Ennoble Hc Dmv LLC's NPI number?
The NPI number for Ennoble Hc Dmv LLC is 1104492115. It was assigned to this organization in the NPPES registry on June 1, 2021.
Where is Ennoble Hc Dmv LLC located?
Ennoble Hc Dmv LLC is located at 8115 Maple Lawn Blvd Ste 350, Fulton, MD 20759. The listed phone number is (862) 812-9010.
What is Ennoble Hc Dmv LLC's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.
Is Ennoble Hc Dmv LLC enrolled in Medicare?
Yes. Ennoble Hc Dmv LLC is registered in the Medicare PECOS enrollment system.
When is Ennoble Hc Dmv LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Ennoble Hc Dmv LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 149 clinicians in 6 Medicare specialties reassign their Medicare billing to Ennoble Hc Dmv 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. The largest specialties are Nurse Practitioner (131), Internal Medicine (11) and Family Practice (4). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Ennoble Hc Dmv LLC was last updated on November 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Ennoble Hc Dmv Llc · NPI 1104492115
Geriatric Medicine organization in Fulton, Maryland. Organization record, active in the CMS NPPES registry since June 1, 2021.
## Identity
- **NPI:** 1104492115 (Entity type: Organization)
- **Enumerated:** June 1, 2021
- **Primary specialty:** Family Medicine - Geriatric Medicine · taxonomy 207QG0300X
- **Organization subpart:** No
- **Authorized official:** Kush Das, MANAGER
## Practice location
- **Address:** 8115 MAPLE LAWN BLVD STE 350, Fulton, MD 20759-2683
- **Phone:** (862) 812-9010
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Georgia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 149 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (131), Internal Medicine (11), Family Practice (4); 1 practice at this address and 3 within 10 miles; [full list](https://npiprofile.com/npi/1104492115/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 26, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104492115) · Data from the CMS NPPES public registry.