Individual provider Active NPI

Adilisha Patrom

  • Prosthetist
  • Washington, DC
National Provider Identifier
1023783396
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
Practice address
1002 Florida Ave NE
Washington, DC 20002-3706
Phone
(800) 390-6515
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X Primary

Addresses

Primary practice location

1002 Florida Ave NE
Washington, DC 20002-3706

Mailing address

8715 Lake Edge Dr
Laurel, MD 20723-4908
Phone (202) 999-9722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1023783396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8715 LAKE EDGE DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207234908",
            "telephone_number": "202-999-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 FLORIDA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023706",
            "telephone_number": "800-390-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATROM",
        "first_name": "ADILISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 10, 2021; 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.