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MARYLAND SPECIALTY GROUP LLC
NPI 1114362845
Surgery - Vascular Surgery in Glenn Dale, MD

Active since May 08, 2013
12200 ANNAPOLIS RD, STE 123, GLENN DALE, MD 20769(301) 552-9495(301) 552-9743 Get Directions Write a Review

NPPES record last updated: May 8, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Maryland Specialty Group Llc NPPES

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

MARYLAND SPECIALTY GROUP LLC (NPI 1114362845), doing business as Ultima Care Llc, is a healthcare organization registered as a vascular surgery in Glenn Dale, Maryland and active in the NPI registry since May 2013. The organization lists Naomi Nwagwe, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1114362845
Entity TypeOrganization
Primary Taxonomy2086S0129X
Legal Business NameMARYLAND SPECIALTY GROUP LLC
Location Address12200 ANNAPOLIS RD, STE 123Glenn Dale, MD 20769-9182
Mailing AddressPo Box 2056Bowie, MD 20718-2056 · (301) 552-9495 · Fax (301) 552-9743
Phone(301) 552-9495
Fax(301) 552-9743
Organization SubpartNo
Authorized OfficialNaomi NwagweBilling Manager · (301) 552-9495
Enumeration DateMay 8, 2013
✔ NPI 1114362845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
12200 ANNAPOLIS RD, Glenn Dale, MD 20769
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Other Names 1

Former Legal Business NameUltima Care Llc

Other Identifiers 1

Medicare PING01686MD

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maryland Specialty Group 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 Maryland Specialty Group LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kwasi Debra, MD
Obstetrics/Gynecology
NPI 1972512408
12200 ANNAPOLIS RD STE 123
Glenn Dale, MD 20769
(301) 552-9495
✔ PECOSSame address

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 Maryland Specialty Group LLC's NPI number?

The NPI number for Maryland Specialty Group LLC is 1114362845. It was assigned to this organization in the NPPES registry on May 8, 2013. The provider was formerly known as Ultima Care LLC.

Where is Maryland Specialty Group LLC located?

Maryland Specialty Group LLC is located at 12200 Annapolis Rd Ste 123, Glenn Dale, MD 20769. The listed phone number is (301) 552-9495.

What is Maryland Specialty Group LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Maryland Specialty Group LLC enrolled in Medicare?

Yes. Maryland Specialty Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Maryland Specialty Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Obstetrics/Gynecology) reassigns their Medicare billing to Maryland Specialty Group 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 Maryland Specialty Group LLC was last updated on May 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.