NPIMap

Organization Active NPI

Washington Radiology Associates, PLLC

  • Specialist
  • Potomac, MD
National Provider Identifier
1013235910
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WASHINGTON RADIOLOGY ASSOCIATES, PLLC
Practice address
12505 Park Potomac Ave
Potomac, MD 20854-6801
Phone
(703) 641-9133
Fax
(703) 280-5098
NPI assigned
May 17, 2010
Last updated
Jun 21, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
WASHINGTON RADIOLOGY ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Authorized official

Name
Ian Lande, MDNPI 1053361162
Title
President
Phone
(703) 641-9133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

12505 Park Potomac Ave
Potomac, MD 20854-6801

Mailing address

3015 Williams Dr
Ste 200
Fairfax, VA 22031-4623
Phone (703) 641-9133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000969 DC Part B Supplier - Clinic/Group Practice 8729972302 Receives reassigned benefits from 52 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, DC; Rockville, MD; Arlington, VA; Bethesda, MD; Chevy Chase, MD; Fairfax, VA; Germantown, MD; Greenbelt, MD…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Washington Rdlgy Assoc PL10 organizations share this tax ID, including this one
Part of
Washington Rdlgy Assoc PL

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12505 Park Potomac Ave
Potomac, MD 20854
Phone (703) 641-9133

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1013235910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 WILLIAMS DR",
            "address_2": "STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314623",
            "telephone_number": "703-641-9133",
            "fax_number": "703-280-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 PARK POTOMAC AVE",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208546801",
            "telephone_number": "703-641-9133",
            "fax_number": "703-280-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON RADIOLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON RADIOLOGY ASSOCIATES, PC",
        "enumeration_date": "2010-05-17",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "LANDE",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-641-9133",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.