NPIMap

Organization Active NPI

Mycare LLC

  • Developmental Disabilities Clinic/Center
  • Washington, DC
National Provider Identifier
1023730892
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
MYCARE LLC
Practice address
1802 Vernon St NW # 1022
Washington, DC 20009-1217
Phone
(508) 345-0973
NPI assigned
Sep 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Jude Timah Tatabod, RNNPI 1780317727
Title
Ceo
Phone
(508) 345-0973

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

1802 Vernon St NW # 1022
Washington, DC 20009-1217

Mailing address

1802 Vernon St NW # 1022
Washington, DC 20009-1217
Phone (508) 345-0973

Other names 1

  • Mycare LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Laptop Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

1802 Vernon St NW
#1022
Washington, DC 20009
Phone (508) 345-0973

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1023730892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 VERNON ST NW # 1022",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200091217",
            "telephone_number": "508-345-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 VERNON ST NW # 1022",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200091217",
            "telephone_number": "508-345-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "TATABOD",
        "authorized_official_first_name": "JUDE",
        "authorized_official_middle_name": "TIMAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "508-345-0973",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1802 Vernon St NW # 1022",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200091217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mycare LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.