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POOLESVILLE FAMILY PRACTICE LLC
NPI 1790953065
Family Medicine in Poolesville, MD

Active since February 20, 2008
19710 FISHER AVE, SUITE J, POOLESVILLE, MD 20837(301) 972-7600(301) 972-8006 Get Directions Write a Review

NPPES record last updated: February 20, 2008. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Poolesville Family Practice Llc NPPES

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

POOLESVILLE FAMILY PRACTICE LLC (NPI 1790953065) is a healthcare organization registered as a family medicine in Poolesville, Maryland and active in the NPI registry since February 2008. The organization lists Amar Venkat Duggirala, Family Physician, as its authorized official.

NPPES Registry Identity

NPI1790953065
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePOOLESVILLE FAMILY PRACTICE LLC
Location Address19710 FISHER AVE, SUITE JPoolesville, MD 20837-0108
Mailing Address19710 Fisher Ave, Suite J, Po Box 108Poolesville, MD 20837-2098 · (301) 972-7600 · Fax (301) 972-8006
Phone(301) 972-7600
Fax(301) 972-8006
Organization SubpartNo
Authorized OfficialAmar Venkat DuggiralaFamily Physician · (301) 972-7600
Enumeration DateFebruary 20, 2008
✔ NPI 1790953065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MD · H61505
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.
19710 FISHER AVE, Poolesville, MD 20837
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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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Poolesville Family Practice Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Poolesville Family Practice LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Katherine Kirksey, D.O.
Family Practice
NPI 1457672206
19710 FISHER AVE STE J
Poolesville, MD 20837
(301) 972-7600
✔ PECOS✔ Accepts MedicareSame address
Stephanie Mckenney Groff, DO
Family Practice
NPI 1700346137
19710 FISHER AVE STE J
Poolesville, MD 20837
(301) 972-7600
✔ PECOS✔ Accepts MedicareSame address
Amar Duggirala, D.O.
Family Practice
NPI 1588672190
19710 FISHER AVE SUITE J
Poolesville, MD 20837
(301) 972-7600
✔ 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 Poolesville Family Practice LLC's NPI number?

The NPI number for Poolesville Family Practice LLC is 1790953065. It was assigned to this organization in the NPPES registry on February 20, 2008.

Where is Poolesville Family Practice LLC located?

Poolesville Family Practice LLC is located at 19710 Fisher Ave Suite J, Poolesville, MD 20837. The listed phone number is (301) 972-7600.

What is Poolesville Family Practice LLC's specialty?

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

Is Poolesville Family Practice LLC enrolled in Medicare?

Yes. Poolesville Family Practice LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Poolesville Family Practice LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Family Practice, reassign their Medicare billing to Poolesville Family Practice 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. Of these, 3 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 Poolesville Family Practice LLC was last updated on February 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.