Individual provider Active NPI

Wilton O R Nedd, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Washington, DC
National Provider Identifier
1003835034
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD14391 Issued in DC
Practice address
1328 Southern Ave SE Ste 302
Washington, DC 20032-4689
Phone
(202) 574-6055
Fax
(202) 373-5956
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD14391 DC Primary

Addresses

Primary practice location

1328 Southern Ave SE Ste 302
Washington, DC 20032-4689

Mailing address

1310 Southern Ave SE
Washington, DC 20032-4623
Phone (202) 574-6055

Other identifiers 1

IdentifierTypeStateIssuer
016400132MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051207000896 DC Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 9739100686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Howard University College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Cardiology Associates LLCGroup PAC ID 8527029743, 9 clinicians

Practice addresses (Care Compare)

7474 Greenway Ctr Dr
Suite 1100
Greenbelt, MD 20770-3500
Phone (301) 441-3050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Cardiology Associates, LLC CurrentSince May 1, 2014 Accepting new patients

Locations

7474 Greenway Center Dr
Ste 1100
Greenbelt, MD 20770
Phone 3014413050138

1450 Mercantile Ln
Ste 151
Uppr Marlboro, MD 20774
Phone (301) 322-8014

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1003835034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324623",
            "telephone_number": "202-574-6055",
            "fax_number": "202-373-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 SOUTHERN AVE SE STE 302",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324689",
            "telephone_number": "202-574-6055",
            "fax_number": "202-373-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDD",
        "first_name": "WILTON",
        "middle_name": "O R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "DC",
            "license": "MD14391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016400132",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.