Individual provider Active NPI

Samuel Jonathon Allen, MBBS

  • Psychiatry Physician
  • Takoma Park, MD
National Provider Identifier
1093241739
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD200001291 Issued in DC
Practice address
7015 Sycamore Ave
Takoma Park, MD 20912-4601
Phone
(301) 755-8774
NPI assigned
May 1, 2017
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD200001291 DC Primary

Addresses

Primary practice location

7015 Sycamore Ave
Takoma Park, MD 20912-4601

Mailing address

408 Ethan Allen Ave
Takoma Park, MD 20912-5429
Phone (301) 755-8774

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
I20220616001531 DC Practitioner - Psychiatry 2062891377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McClendon CenterGroup PAC ID 8224031901, 2 clinicians

Practice addresses (Care Compare)

1629 K St NW
Suite 1100
Washington, DC 20006-1640
Phone (202) 745-0073

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD200001291DCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McClendon Center CurrentSince Mar 12, 2022 Accepting new patients

Locations

1313 New York Ave NW
Washington, DC 20005
Phone (202) 737-6191

1338 N Capitol St NW
Washington, DC 20002
Phone (202) 745-0073

1338 N Capitol St NW
Apt 201
Washington, DC 20002
Phone (202) 714-3440

1629 K St NW
Ste 1100
Washington, DC 20006
Phone (202) 320-8182

Organizations & group practices 1

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1093241739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 ETHAN ALLEN AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209125429",
            "telephone_number": "301-755-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 SYCAMORE AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209124601",
            "telephone_number": "301-755-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SAMUEL",
        "middle_name": "JONATHON",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD200001291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

Verify at the official NPI Registry.