Individual provider Active NPI

Martha Deborah Rose, CRNP

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1053566406
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN40365 Issued in DC
Practice address
900 23Rd St NW
Washington, DC 20037-2342
Phone
(202) 715-4000
NPI assigned
Nov 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R116317 MD
Family Nurse Practitioner 363LF0000X RN40365 DC Primary

Addresses

Primary practice location

900 23Rd St NW
Washington, DC 20037-2342

Mailing address

20416 Bloomingville CT
Germantown, MD 20876-5648
Phone (301) 540-8647

Other practice location 1

20416 Bloomingville Ct
Germantown, MD 20876-5648
Phone (301) 540-8647

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120312000585 DC Practitioner - Nurse Practitioner 4284893215 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 Forest Glen Rd
Silver Spring, MD 20910-1460
Phone (301) 754-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN40365DCMDFamily Nurse Practitioner
R116317MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
District Hospital Partners LP Family CurrentSince Jun 26, 2019 Accepting new patients
Medical Faculty Associates, Inc CurrentSince Feb 27, 2012 Accepting new patients
District Hospital Partners L P Family CurrentSince Jun 26, 2019 Accepting new patients

Locations

2021 K St NW
Ste 408
Washington, DC 20006
Phone (202) 223-1024

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1227744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1053566406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20416 BLOOMINGVILLE CT",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208765648",
            "telephone_number": "301-540-8647",
            "fax_number": "301-540-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-715-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20416 Bloomingville Ct",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208765648",
            "country_code": "US",
            "telephone_number": "301-540-8647",
            "fax_number": "301-540-8647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MARTHA",
        "middle_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-27",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R116317",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN40365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.