MIRA MACE MEDICAL GROUP PA
NPI 1487532289
Family Medicine in North Bethesda, MD

Active since August 21, 2025
11810 GRAND PARK AVE STE 500, NORTH BETHESDA, MD 20852(332) 296-0021 Get Directions Write a Review

NPPES record last updated: June 3, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 3, 2026, Feb 2, 2026 (2 updates tracked since 2026).

About Mira Mace Medical Group Pa NPPES

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

MIRA MACE MEDICAL GROUP PA (NPI 1487532289) is a healthcare organization registered as a family medicine in North Bethesda, Maryland and active in the NPI registry since August 2025. The organization lists Prashant Kumar, Operations Administrator, as its authorized official.

NPPES Registry Identity

NPI1487532289
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMIRA MACE MEDICAL GROUP PA
Location Address11810 GRAND PARK AVE STE 500North Bethesda, MD 20852-8679
Mailing Address1111b S Governors Ave Ste 39475Dover, DE 19904-6903
Organization SubpartNo
Authorized OfficialPrashant KumarOperations Administrator · (332) 296-0021
Enumeration DateAugust 21, 2025
Last NPPES UpdateJune 3, 20262 updates tracked since enumeration
NPPES CertifiedJune 3, 2026
✔ NPI 1487532289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
11810 GRAND PARK AVE STE 500, North Bethesda, MD 20852

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

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Mira Mace Medical Group PA, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (5)

Family Practice
NPI 1447749890
1000 MONTAUK HWY
West Islip, NY 11795
(631) 376-4163
✔ PECOS✔ Accepts Medicare233 mi
Family Practice
NPI 1336282011
274 EASTCHESTER DR STE 120
High Point, NC 27262
(336) 542-2992
✔ PECOS✔ Accepts Medicare265 mi
Internal Medicine
NPI 1134136369
1879 BAY SCOTT CIR STE 112
Naperville, IL 60540
(630) 369-6644
✔ PECOS✔ Accepts Medicare612 mi
Family Practice
NPI 1811448103
1201 W FRANK AVE
Lufkin, TX 75904
(936) 634-8111
✔ PECOS✔ Accepts Medicare1,127 mi
Family Practice
NPI 1245233717
320 LINCOLN BLVD SUITE #100
Venice, CA 90291
(310) 697-8126
✔ PECOS✔ Accepts Medicare

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 Mira Mace Medical Group PA's NPI number?

The NPI number for Mira Mace Medical Group PA is 1487532289. It was assigned to this organization in the NPPES registry on August 21, 2025.

Where is Mira Mace Medical Group PA located?

Mira Mace Medical Group PA is located at 11810 Grand Park Ave Ste 500, North Bethesda, MD 20852. The listed phone number is (332) 296-0021.

What is Mira Mace Medical Group PA's specialty?

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

Is Mira Mace Medical Group PA enrolled in Medicare?

Yes. Mira Mace Medical Group PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mira Mace Medical Group PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Mira Mace 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 Family Practice (4) and Internal Medicine (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mira Mace Medical Group PA accept?

Health plans from Blue Cross and Blue Shield of Texas list Mira Mace Medical Group PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mira Mace Medical Group PA was last updated on June 3, 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.