NPIMap

Organization Active NPI

Family Care Associates

  • Primary Care Clinic/Center
  • Gaithersburg, MD
National Provider Identifier
1003151291
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
FAMILY CARE ASSOCIATES
Practice address
702 Russell Ave Ste 100
Gaithersburg, MD 20877-2605
Phone
(301) 330-0006
Fax
(301) 330-0444
NPI assigned
Nov 29, 2012
Last updated
Jul 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Gennady Vinokur
Title
Manager
Phone
(301) 330-0006

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

702 Russell Ave Ste 100
Gaithersburg, MD 20877-2605

Mailing address

702 Russell Ave Ste 100
Gaithersburg, MD 20877-2605
Phone (301) 330-0006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130326000017 DC Part B Supplier - Clinic/Group Practice 8325283229 Receives reassigned benefits from 17 practitioners
Practice locations: Gaithersburg, MD; Silver Spring, MD

National Provider Directory

National Provider Directory

Locations

3508 Worthington Blvd
Unit 101
Frederick, MD 21704
Phone (301) 330-0006

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJIAAA

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1003151291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 RUSSELL AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772605",
            "telephone_number": "301-330-0006",
            "fax_number": "301-330-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 RUSSELL AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772605",
            "telephone_number": "301-330-0006",
            "fax_number": "301-330-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-29",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "VINOKUR",
        "authorized_official_first_name": "GENNADY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "301-330-0006",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.