Individual provider Active NPI

Wylie Roland Rogers

  • Anesthesiology Physician
  • Washington, DC
National Provider Identifier
1093874505
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD035838 Issued in DC
Practice address
2120 L St NW
Lbby Level
Washington, DC 20037-1527
Phone
(202) 715-4600
Fax
(202) 862-5489
NPI assigned
Dec 8, 2006
Last updated
Apr 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD035838 DC Primary

Addresses

Primary practice location

2120 L St NW
Lbby Level
Washington, DC 20037-1527

Mailing address

2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone (202) 741-3333

Other practice location 1

2041 Georgia Ave NW Ste B105
Washington, DC 20060-1527
Phone (202) 865-6100

Other identifiers 2

IdentifierTypeStateIssuer
037553500MedicaidDC
010239052MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250226002949 IL Practitioner - Anesthesiology 1951318708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Drexel University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ambulatory Anesthesiologists of Chicago LLCGroup PAC ID 4284605171, 6 clinicians

Practice addresses (Care Compare)

60 E Delaware PL
FL 15
Chicago, IL 60611-1998
Phone (312) 440-5150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD035838DCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesiologists of Chicago, LLC Anesthesiology CurrentSince Feb 1, 2025 Accepting new patients
Medical Faculty Associates, Inc Anesthesiology Past Accepting new patients

Locations

7456 S State Rd
Ste 300
Bedford Park, IL 60638
Phone (708) 424-6500

60 E Delaware Pl
Fl 15
Chicago, IL 60611
Phone (312) 440-5150

27650 Ferry Rd
Warrenville, IL 60555
Phone (630) 225-2345

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1093874505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "202-741-3333",
            "fax_number": "202-741-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 L ST NW",
            "address_2": "LBBY LEVEL",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371527",
            "telephone_number": "202-715-4600",
            "fax_number": "202-862-5489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 Georgia Ave NW Ste B105",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200601527",
            "country_code": "US",
            "telephone_number": "202-865-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "WYLIE",
        "middle_name": "ROLAND",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "DC",
            "license": "MD035838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037553500",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010239052",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.