Fort Washington Park Pediatrics P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D63446 Issued in MD

Legal business name

FORT WASHINGTON PARK PEDIATRICS P.C.

Practice address

6830 Hospital Dr
Suite 206
Rosedale, MD 21237-4373

Phone

(410) 238-5390

Fax

(410) 238-5396

NPI assigned

Mar 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Edwin F Aguilar, M.D

Title

President

Phone

(914) 316-7066

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edwin Francisco Aguilar Lopez, M.D.

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1073619375

  DC

  Medicare reassignment NPD
• Randi Nicole Bouchillon, DNP, FNP-C

  • Family Nurse Practitioner
  • Prince Frederick, MD
  • NPI 1437888138
  NPD (past)
• Julie Ahyoung Kim, PA-C

  • Physician Assistant
  • White Plains, MD
  • NPI 1225824337
  NPD (past)
• Herberth Marcelo Ochoa Flores, MD

  • Pediatrics Physician
  • Fort Washington, MD
  • NPI 1407217243
  NPD (past)
• Sammir Perez Sanjuanelo, MD

  • Pediatrics Physician
  • Riverdale, MD
  • NPI 1326485764
  NPD (past)

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1023558384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 HOSPITAL DR",
            "address_2": "SUITE 206",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374373",
            "telephone_number": "410-238-5390",
            "fax_number": "410-238-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 HOSPITAL DR",
            "address_2": "SUITE 206",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374373",
            "telephone_number": "410-238-5390",
            "fax_number": "410-238-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WASHINGTON PARK PEDIATRICS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "AGUILAR",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-316-7066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D63446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline E Floyd, LMSW
• Cletus Fonmedig, DDS
• Jill K Forbes, M.S., CCC-SLP
• Forever Diaz Salon & Spa, LLC
• Forever Hope Behavioral Health, LLC
• Valeria Danielle Foster
• Franklin Family Dental Care
• Franklin Square Hospital Center, Inc
• Olivia Conner Fraser, LGPC
• Andrew Joseph Friend, LMSW

• Pediatrics Physician in Rosedale, MD
• Providers in Rosedale, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.