Dilys Fan, MSN, AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R209031 Issued in MD

Practice address

19703 Executive Park Cir
Germantown, MD 20874-2639

Phone

(301) 540-9447

NPI assigned

Dec 23, 2018

Last updated

Jan 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Medical Care LLC

  • Internal Medicine Physician
  • Germantown, MD
  • NPI 1730398538

  DC

  Medicare reassignment
• Advanced Medical Care LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Germantown, MD
  • NPI 1184403214
  NPD (past)

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

{
    "created_epoch": "1545523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1033681440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 FERRARA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064706",
            "telephone_number": "301-946-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19703 EXECUTIVE PARK CIR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742639",
            "telephone_number": "301-540-9447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3925 Ferrara Dr",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209064709",
            "country_code": "US",
            "telephone_number": "301-946-6623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAN",
        "first_name": "DILYS",
        "credential": "MSN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-23",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R209031",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R209031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vida Falahatian
• Family Dental Group of Germantown
• Family Healthcare, P.C.
• Family Medical Supplies, LLC
• Family Services Inc
• Ted Fan
• Bernadette Fankam
• Renee Fanning
• Marceline Merveille Fannou
• Eyoel Yohannes Fantaye, MD

• Adult Health Nurse Practitioner in Germantown, MD
• Providers in Germantown, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.