NPIMap

Organization Active NPI

Professional Services of Holy Cross

  • Health Service Clinic/Center
  • Montgomery Village, MD
National Provider Identifier
1043961071
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
PROFESSIONAL SERVICES OF HOLY CROSS
Practice address
18530 Office Park Dr
Montgomery Village, MD 20886-0586
Phone
(301) 557-1540
NPI assigned
Jan 11, 2022
Organization subpart
Yes
Parent organization
HOLY CROSS HEALTH, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Authorized official

Name
Julie Keese
Title
VP & Cfo
Phone
(301) 754-7201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

18530 Office Park Dr
Montgomery Village, MD 20886-0586

Mailing address

PO Box 531863
Atlanta, GA 30353-1863
Phone (301) 754-7035

Other names 1

  • Holy Cross Health Partners Progressive Medical Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050916000745 DC Part B Supplier - Clinic/Group Practice 3779516992 Receives reassigned benefits from 283 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wheaton, MD; Silver Spring, MD; Rockville, MD; Largo, MD; Montgomery Village, MD; Beltsville, MD; Bethesda, MD; Gaithersburg, MD…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Professional Services of Holy Cross26 organizations share this tax ID, including this one
Part of
Cardio Holy Cross Hosp

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

11700 Beltsville Dr
Beltsville, MD 20705
Phone (703) 460-9338

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1043961071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531863",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303531863",
            "telephone_number": "301-754-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18530 OFFICE PARK DR",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208860586",
            "telephone_number": "301-557-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SERVICES OF HOLY CROSS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLY CROSS HEALTH, INC",
        "enumeration_date": "2022-01-11",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "KEESE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "301-754-7201"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy Cross Health Partners Progressive Medical Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holy Cross Health Partners Progressive Medical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery Village, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.