MIRA MACE MEDICAL GROUP PA – NPI #1487532289
Family Medicine

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.

MIRA MACE MEDICAL GROUP PA is a provider located in NORTH BETHESDA, MD. NPPES has assigned the NPI number 1487532289 to MIRA MACE MEDICAL GROUP PA on August 21, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was last updated on Feb 02, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MIRA MACE MEDICAL GROUP PA below.

NPI Profile for
MIRA MACE MEDICAL GROUP PA

NPI Number
1487532289
Enumeration Date

(about 10 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MIRA MACE MEDICAL GROUP PA
Primary location
11810 GRAND PARK AVE STE 500
NORTH BETHESDA, MD 20852-8679
Phone: (332) 296-0021 Fax:
Mailing address
1111B S GOVERNORS AVE STE 39475
DOVER, DE 19904-6903
Phone: Fax:
Organization Subpart
No
Authorized Official
JAGADEESH JAGARLAMUDI
OPERATIONS ADMINISTRATOR
Phone: (332) 296-0021
Updated
Certification Date
Feb 02, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.