Organization Active NPI

Pediatric Professionals, PC

  • Pediatrics Physician
  • Washington, DC
National Provider Identifier
1093976813
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD035063 Issued in DC
Legal business name
PEDIATRIC PROFESSIONALS, PC
Practice address
106 Irving St NW
Ste 212
Washington, DC 20010-2927
Phone
(202) 726-5800
Fax
(202) 829-3753
NPI assigned
Jun 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Mr. Yared Belai, MBA
Title
Business Manager/Secretary
Phone
(301) 529-8832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD035063 DC Primary

Addresses

Primary practice location

106 Irving St NW
Ste 212
Washington, DC 20010-2927

Mailing address

106 Irving St NW
Ste 212
Washington, DC 20010-2927
Phone (202) 726-5800

Other identifiers 2

IdentifierTypeStateIssuer
400605400MedicaidMD
045523900MedicaidDC

National Provider Directory

National Provider Directory

Locations

8609 2nd Ave
Ste 407B
Silver Spring, MD 20910

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1093976813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 IRVING ST NW",
            "address_2": "STE 212",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102927",
            "telephone_number": "202-726-5800",
            "fax_number": "202-829-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 IRVING ST NW",
            "address_2": "STE 212",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102927",
            "telephone_number": "202-726-5800",
            "fax_number": "202-829-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PROFESSIONALS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "BELAI",
        "authorized_official_first_name": "YARED",
        "authorized_official_title_or_position": "BUSINESS MANAGER/SECRETARY",
        "authorized_official_telephone_number": "301-529-8832",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD035063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400605400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045523900",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.