Individual provider Active NPI

Randall Drake Ehrbar, PSYD

  • Psychologist
  • Bethesda, MD
National Provider Identifier
1043248644
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 1000756 Issued in DC
Practice address
4400 East West Hwy
Suite 1028
Bethesda, MD 20814-4524
Phone
(301) 204-1411
Fax
(301) 907-3241
NPI assigned
Jun 30, 2006
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 1000756 DC Primary
Psychologist 103T00000X 05164 MD

Addresses

Primary practice location

4400 East West Hwy
Suite 1028
Bethesda, MD 20814-4524

Mailing address

4400 East West Hwy
Suite 1028
Bethesda, MD 20814-4524
Phone (301) 204-1411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120830000147 DC Practitioner - Clinical Psychologist 1658301585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whitman-Walker Clinic, Inc.Group PAC ID 6507755196, 28 clinicians

Practice addresses (Care Compare)

1201 Sycamore Dr SE
Washington, DC 20032-5956
Phone (202) 745-7000

1377 R St NW
Washington, DC 20009-6293
Phone (202) 745-7000

1432 U St NW
Washington, DC 20009-3916
Phone (202) 797-3500

1701 14TH St NW
Washington, DC 20009-4308
Phone (202) 745-7000

1734 14TH St NW
Washington, DC 20009-4796
Phone (202) 939-7801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 1000756DCMDPsychologist
05164MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Whitman-Walker Clinic Inc. CurrentSince Jul 17, 2012 Accepting new patients
Whitman-Walker Clinic, Inc CurrentSince Jul 17, 2012 Accepting new patients

Locations

1201 Sycamore Dr SE
Washington, DC 20032
Phone (202) 745-7000

1377 R St NW
Fl 2
Washington, DC 20009
Phone (202) 745-7000

1377 R St NW
Ste 200
Washington, DC 20009
Phone (202) 745-7000

1701 14th St NW
Washington, DC 20009
Phone (202) 745-7000

1734 14th St NW
Washington, DC 20009
Phone (202) 939-7801

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1043248644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 EAST WEST HWY",
            "address_2": "SUITE 1028",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144524",
            "telephone_number": "301-204-1411",
            "fax_number": "301-907-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 EAST WEST HWY",
            "address_2": "SUITE 1028",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144524",
            "telephone_number": "301-204-1411",
            "fax_number": "301-907-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRBAR",
        "first_name": "RANDALL",
        "middle_name": "DRAKE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY 1000756",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.