Individual provider Active NPI

Constantine A Stratakis, MD, D(MED)SCI, PHD

  • Clinical Genetics (M.D.) Physician
  • Bethesda, MD
National Provider Identifier
1003428947
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
0101049468 Issued in VA
Practice address
9000 Rockville Pike
Bethesda, MD 20892-0001
Phone
(301) 496-2315
NPI assigned
Aug 21, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 0101049468 VA Primary

Addresses

Primary practice location

9000 Rockville Pike
Bethesda, MD 20892-0001

Mailing address

6506 Tilden LN
North Bethesda, MD 20852-3745
Phone (301) 315-2178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0101049468VAMDClinical Genetics (M.D.) Physician

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1003428947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6506 TILDEN LN",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523745",
            "telephone_number": "301-315-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-496-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRATAKIS",
        "first_name": "CONSTANTINE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD, D(MED)SCI, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "VA",
            "license": "0101049468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.