FAMILY MEDICINE SHADY GROVE, LLC
NPI 1588093371
Family Medicine in Rockville, MD
About Family Medicine Shady Grove, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAMILY MEDICINE SHADY GROVE, LLC (NPI 1588093371) is a healthcare organization registered as a family medicine in Rockville, Maryland and active in the NPI registry since November 2013. The organization lists Manisha Kalra, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
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)
Family Medicine Shady Grove, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 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.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Family Medicine Shady Grove, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 Family Medicine Shady Grove's NPI number?
The NPI number for Family Medicine Shady Grove is 1588093371. It was assigned to this organization in the NPPES registry on November 2, 2013. The provider is doing business as Family Medicine Shady Grove, LLC.
Where is Family Medicine Shady Grove located?
Family Medicine Shady Grove is located at 15215 Shady Grove Rd Ste 304, Rockville, MD 20850. The listed phone number is (301) 284-8990.
What is Family Medicine Shady Grove's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Family Medicine Shady Grove enrolled in Medicare?
Yes. Family Medicine Shady Grove is registered in the Medicare PECOS enrollment system.
When is Family Medicine Shady Grove'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 (District of Columbia, Clinic/Group Practice) is due for revalidation by February 28, 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 Family Medicine Shady Grove?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Family Medicine Shady Grove. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Family Medicine Shady Grove was last updated on April 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Family Medicine Shady Grove, Llc · NPI 1588093371
Family Medicine organization in Rockville, Maryland. Organization record, active in the CMS NPPES registry since November 2, 2013.
## Identity
- **NPI:** 1588093371 (Entity type: Organization)
- **Enumerated:** November 2, 2013
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Family Medicine Shady Grove
- **Organization subpart:** No
- **Authorized official:** Manisha Kalra, PHYSICIAN
## Practice location
- **Address:** 15215 SHADY GROVE RD STE 304, Rockville, MD 20850-0200
- **Phone:** (301) 284-8990 · **Fax:** (301) 569-4293
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, District of Columbia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Family Practice) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 21, 2014
- **Other identifiers:** Medicare UPIN H71149 (MD)
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Source: [NPI Profile](https://npiprofile.com/npi/1588093371) · Data from the CMS NPPES public registry.