Pediatric Healthcare Associates Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC HEALTHCARE ASSOCIATES INC

Practice address

404 East Charles Street
Laplata, MA 20646

Phone

(301) 751-6058

Fax

(301) 392-0892

NPI assigned

Nov 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tollese Bankett, MDNPI 1831409218

Title

President

Phone

(301) 753-1918

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Tollese H Bankett, M.D.

  • Pediatrics Physician
  • La Plata, MD
  • NPI 1831409218
  NPD (past) Authorized official
• Jean Mountain Eisenbrey, M.D.

  • Pediatric Adolescent Medicine Physician
  • Waldorf, MD
  • NPI 1609932185
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013081223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 GRANDVIEW PLACE",
            "city": "LAPLATA",
            "state": "MA",
            "postal_code": "206462846",
            "telephone_number": "301-753-1918",
            "fax_number": "301-392-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 EAST CHARLES STREET",
            "city": "LAPLATA",
            "state": "MA",
            "postal_code": "20646",
            "telephone_number": "301-751-6058",
            "fax_number": "301-392-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEALTHCARE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANKETT",
        "authorized_official_first_name": "TOLLESE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-753-1918",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.