Individual provider Active NPI

Marc Andrew Nemiroff, PH.D.

  • Family Psychologist
  • Potomac, MD
National Provider Identifier
1053539924
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
License
00972 Issued in MD
Practice address
8513 Aqueduct Rd
Potomac, MD 20854-6209
Phone
(301) 294-0032
Fax
(301) 294-1162
NPI assigned
Apr 23, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 00972 MD
Clinical Psychologist 103TC0700X 000972 MD
Clinical Child & Adolescent Psychologist 103TC2200X 00972 MD
Family Psychologist 103TF0000X 00972 MD Primary
Group Psychotherapy Psychologist 103TP2701X 00972 MD

Addresses

Primary practice location

8513 Aqueduct Rd
Potomac, MD 20854-6209

Mailing address

8513 Aqueduct Rd
Potomac, MD 20854-6209
Phone (301) 294-0032

Other identifiers 3

IdentifierTypeStateIssuer
0810000767OtherVA0810000767
PSY812OtherDC812
00972OtherMD972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Oct 1, 2014 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
000972MDMDClinical Psychologist
00972MDMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1053539924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8513 AQUEDUCT RD",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208546209",
            "telephone_number": "301-294-0032",
            "fax_number": "301-294-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8513 AQUEDUCT RD",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208546209",
            "telephone_number": "301-294-0032",
            "fax_number": "301-294-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMIROFF",
        "first_name": "MARC",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "00972",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "000972",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "00972",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MD",
            "license": "00972",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MD",
            "license": "00972",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0810000767",
            "identifier": "0810000767",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "812",
            "identifier": "PSY812",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "972",
            "identifier": "00972",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

Verify at the official NPI Registry.