1. Home
  2. Directory
  3. Maryland
  4. Crofton
  5. Internal Medicine
  6. NPI Profile

CROFTON MEDICAL GROUP, LLC
NPI 1457308090
Internal Medicine in Crofton, MD

Active since May 28, 2006
1667 CROFTON CTR STE 5, CROFTON, MD 21114(410) 721-2700(410) 721-8874 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Crofton Medical Group, Llc NPPES

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

CROFTON MEDICAL GROUP, LLC (NPI 1457308090) is a healthcare organization registered as an internal medicine in Crofton, Maryland and active in the NPI registry since May 2006. The organization lists Mirza Mohammed Nusairee, Physician, as its authorized official.

NPPES Registry Identity

NPI1457308090
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCROFTON MEDICAL GROUP, LLC
Location Address1667 CROFTON CTR STE 5Crofton, MD 21114-1389
Mailing Address1667 Crofton Ctr Ste 5Crofton, MD 21114-1389 · (410) 721-2700 · Fax (410) 721-8874
Phone(410) 721-2700
Fax(410) 721-8874
Organization SubpartNo
Authorized OfficialMirza Mohammed NusaireePhysician · (410) 721-2700
Enumeration DateMay 28, 2006
Last NPPES UpdateJune 23, 2026
NPPES CertifiedJune 23, 2026
✔ NPI 1457308090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1667 CROFTON CTR STE 5, Crofton, MD 21114
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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)

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

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

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.

StateEnrollment IDDue date
StateMarylandEnrollment IDO20041215000797Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Crofton Medical Group, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mirza Nusairee, M.D
Internal Medicine
NPI 1043257256
1667 CROFTON CTR STE 5
Crofton, MD 21114
(410) 721-2700
✔ PECOS✔ Accepts MedicareSame 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 Crofton Medical Group, LLC's NPI number?

The NPI number for Crofton Medical Group, LLC is 1457308090. It was assigned to this organization in the NPPES registry on May 28, 2006.

Where is Crofton Medical Group, LLC located?

Crofton Medical Group, LLC is located at 1667 Crofton Ctr Ste 5, Crofton, MD 21114. The listed phone number is (410) 721-2700.

What is Crofton Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Crofton Medical Group, LLC enrolled in Medicare?

Yes. Crofton Medical Group, LLC is registered in the Medicare PECOS enrollment system.

When is Crofton Medical Group, 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 (Maryland, Clinic/Group Practice) is due for revalidation by March 31, 2027. 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 Crofton Medical Group, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Crofton Medical 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 Crofton Medical Group, LLC was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.