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CENTENNIAL MEDICAL GROUP, PA
NPI 1336918275
Family Medicine in Clarksville, MD

Active since December 20, 2023
6339 TEN OAKS RD STE 100, CLARKSVILLE, MD 21029(410) 730-3399(443) 478-4747 Get Directions Write a Review

NPPES record last updated: September 18, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Centennial Medical Group, Pa NPPES

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

CENTENNIAL MEDICAL GROUP, PA (NPI 1336918275) is a healthcare organization registered as a family medicine in Clarksville, Maryland and active in the NPI registry since December 2023. The organization lists Rajiv Dua, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1336918275
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCENTENNIAL MEDICAL GROUP, PA
Location Address6339 TEN OAKS RD STE 100Clarksville, MD 21029-1141
Mailing Address6230 Old Dobbin Ln Ste 230Columbia, MD 21045-5884 · (410) 730-3399 · Fax (443) 478-4747
Phone(410) 730-3399
Fax(443) 478-4747
Organization SubpartNo
Authorized OfficialRajiv DuaMedical Director · (410) 730-3399
Enumeration DateDecember 20, 2023
Last NPPES UpdateSeptember 18, 2024
NPPES CertifiedSeptember 18, 2024
✔ NPI 1336918275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal MedicineTaxonomy 207R00000X
6339 TEN OAKS RD STE 100, Clarksville, MD 21029
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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)

Centennial Medical Group, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

41

Medicare enrollment records show 41 clinicians reassign Medicare billing to Centennial Medical Group, PA, which bills Medicare for the services they deliver. Of these, 19 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Nurse Practitioner20
Physical Therapist in Private Practice7
Family Practice6
Internal Medicine4
Cardiovascular Disease (Cardiology)1
Emergency Medicine1
Pediatric Medicine1
Psychiatry1

Nearest to this location (20)

See all 41
Stephanie Jenkins
Nurse Practitioner
NPI 1194322636
5755 CEDAR LN
Columbia, MD 21044
(410) 740-7890
✔ PECOS✔ Accepts Medicare3.3 mi
Eli Fontanilla, PT
Physical Therapist in Private Practice
NPI 1568686426
10981 JOHNS HOPKINS RD
Laurel, MD 20723
(410) 730-3399
✔ Accepts Medicare4.3 mi
Amy Lamparella, CRNP
Nurse Practitioner
NPI 1093704652
4801 DORSEY HALL DR SUITE 201
Ellicott City, MD 21042
(410) 997-7660
✔ PECOS✔ Accepts Medicare6.3 mi
Marie-Alberte Boursiquot, M.D
Internal Medicine
NPI 1578571618
4801 DORSEY HALL DR STE 201
Ellicott City, MD 21042
(410) 997-7660
✔ PECOS✔ Accepts Medicare6.3 mi
Efrahim Fernandez
Physical Therapist in Private Practice
NPI 1942886908
10120 BALTIMORE NATIONAL PIKE
Ellicott City, MD 21042
(410) 730-3399
✔ Accepts Medicare6.8 mi
Simone Brady, CRNP
Nurse Practitioner
NPI 1144202383
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Jacinth Brooks, MD
Family Practice
NPI 1225117211
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Sharon Cox, M.D.
Internal Medicine
NPI 1487904702
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Rajiv Dua, M.D.
Family Practice
NPI 1043326945
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Joseph Gibbons, M.D.
Internal Medicine
NPI 1023124922
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Rena Johnson, M.D.
Family Practice
NPI 1447267661
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
David Luebbert, M.D.
Family Practice
NPI 1922419464
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Breanna Roach
Nurse Practitioner
NPI 1932050143
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Siobhan Yoshida, FNP
Nurse Practitioner
NPI 1881883205
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Bisma Zulfiqar, MD
Family Practice
NPI 1538510375
6250 OLD DOBBIN LN
Columbia, MD 21045
(410) 730-3399
✔ PECOS✔ Accepts Medicare7.1 mi
Poonam Desai
Physical Therapist in Private Practice
NPI 1689026734
8186 LARK BROWN RD STE 302
Elkridge, MD 21075
(410) 730-3399
✔ Accepts Medicare8.2 mi
Ijeoma Okonkwo
Nurse Practitioner
NPI 1023625381
6480 OLD WATERLOO RD
Elkridge, MD 21075
(410) 799-0291
✔ PECOS✔ Accepts Medicare8.2 mi
Elisabeth Jakobsen, PT
Physical Therapist in Private Practice
NPI 1932195872
8174 LARK BROWN RD SUITE 101
Elkridge, MD 21075
(410) 799-9988
✔ Accepts Medicare8.2 mi
James Brothers, NP
Nurse Practitioner
NPI 1487704862
7300 VAN DUSEN RD
Laurel, MD 20707
(301) 497-7954
✔ PECOS✔ Accepts Medicare8.9 mi
Tova Green, CRNP-FAMILY
Nurse Practitioner
NPI 1699348961
8811 FLAGSTONE DR
Randallstown, MD 21133
(443) 345-9448
✔ PECOS✔ Accepts Medicare14 mi
See all 41 clinicians

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 Centennial Medical Group, PA's NPI number?

The NPI number for Centennial Medical Group, PA is 1336918275. It was assigned to this organization in the NPPES registry on December 20, 2023.

Where is Centennial Medical Group, PA located?

Centennial Medical Group, PA is located at 6339 Ten Oaks Rd Ste 100, Clarksville, MD 21029. The listed phone number is (410) 730-3399.

What is Centennial Medical Group, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Centennial Medical Group, PA enrolled in Medicare?

Yes. Centennial Medical Group, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Centennial Medical Group, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 41 clinicians in 8 Medicare specialties reassign their Medicare billing to Centennial Medical Group, PA. 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 (20), Physical Therapist in Private Practice (7) and Family Practice (6). Of these, 19 practice 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 Centennial Medical Group, PA was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.