Alan R. Vinitsky, MD LCC | NPI 1104127489

Key facts

NPI: 1104127489
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
License: D0022180 (MD)
Legal business name: ALAN R. VINITSKY, MD LCC
Practice address: 902 Wind River LN
Suite 201
Gaithersburg, MD 20878-1977
Phone: (301) 840-0002
Fax: (301) 417-0262
NPI assigned: Nov 3, 2010
Organization subpart: No

Authorized official

Name: Dr. Alan R Vinitsky, MD NPI 1053410530
Title: Physician
Phone: (301) 840-0002

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

Alan Vinitsky, M.D Internal Medicine Physician · Gaithersburg, MD · NPI 1053410530

Medicare reassignment NPD Authorized official DC · INTERNAL MEDICINE

Medicare participation

Medicare fee-for-service enrollment: Enrolled in DC

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20110218000136	DC	Part B Supplier - Clinic/Group Practice	8224219654	Receives reassigned benefits from 1 practitioner Practice locations: Rockville, MD

National Provider Directory

Locations

902 Wind River Ln
Ste 201
Gaithersburg, MD 20878
Phone (301) 840-0002

16220 Frederick Rd
Ste 210
Gaithersburg, MD 20877
Phone (301) 990-6061

2301 Research Blvd
Ste 220
Rockville, MD 20850
Phone (301) 840-0002

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician Group: 193400000X SINGLE SPECIALTY GROUP	207R00000X	D0022180	MD	Yes

Addresses

Primary practice location

902 Wind River LN
Suite 201
Gaithersburg, MD 20878-1977

Mailing address

902 Wind River LN
Suite 201
Gaithersburg, MD 20878-1977
Phone (301) 840-0002

Other providers in Gaithersburg, MD

All providers in Gaithersburg, MD · Internal Medicine Physician in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.