Individual provider Active NPI

Nicola Sheree Bravo, M.D.

  • Specialist
  • Silver Spring, MD
National Provider Identifier
1073603445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0045375 Issued in MD
Practice address
1730 Elton Rd
Suite 11
Silver Spring, MD 20903-1723
Phone
(301) 439-4303
Fax
(301) 439-4340
NPI assigned
Oct 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0045375 MD Primary

Addresses

Primary practice location

1730 Elton Rd
Suite 11
Silver Spring, MD 20903-1723

Mailing address

1730 Elton Road
Suite 11
Silver Spring, MD 20903
Phone (301) 439-4303

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250912002473 DC Practitioner - Pathology 6406148766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Johns Hopkins University School of Medicine, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1110 23Rd St NW
Washington, DC 20037-1480

4801 Tesla Dr
Suite H
Bowie, MD 20715-4320

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Annapath, Inc CurrentSince May 15, 2025 Accepting new patients
Bethesda Dermatopathology Lab Inc. PastSince May 1, 2016 Accepting new patients

Locations

4801 Tesla Dr
Ste H
Bowie, MD 20715
Phone (240) 413-8943

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073603445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 ELTON ROAD",
            "address_2": "SUITE 11",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "20903",
            "telephone_number": "301-439-4303",
            "fax_number": "301-439-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 ELTON RD",
            "address_2": "SUITE 11",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209031723",
            "telephone_number": "301-439-4303",
            "fax_number": "301-439-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "NICOLA",
        "middle_name": "SHEREE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0045375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.