Organization Active NPI

Psychiatric Center of Northern Virginia

  • Behavioral Neurology & Neuropsychiatry Physician
  • Bethesda, MD
National Provider Identifier
1104464924
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X
Legal business name
PSYCHIATRIC CENTER OF NORTHERN VIRGINIA
Practice address
4300 Montgomery Ave Ste 304a
Bethesda, MD 20814-4444
Phone
(202) 417-6222
Fax
(240) 477-7616
NPI assigned
Dec 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Authorized official

Name
Dr. Carlos Astrada, MDNPI 1558379958
Title
Ceo
Phone
(202) 868-9001

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0040X Primary

Addresses

Primary practice location

4300 Montgomery Ave Ste 304a
Bethesda, MD 20814-4444

Mailing address

13617 Query Mill Rd
North Potomac, MD 20878-3967
Phone (301) 213-3644

Other identifiers 1

IdentifierTypeStateIssuer
740028400MedicaidMD

Other names 1

  • Psychiatric Center of Northern Virginia, Chtd Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250905000556 DC Part B Supplier - Clinic/Group Practice 9234646068 Receives reassigned benefits from 1 practitioner
Practice locations: Bethesda, MD

National Provider Directory

National Provider Directory

Locations

4300 Montgomery Ave
Ste 304
Bethesda, MD 20814

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": "1576022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1104464924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13617 QUERY MILL RD",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208783967",
            "telephone_number": "301-213-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MONTGOMERY AVE STE 304A",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144444",
            "telephone_number": "202-417-6222",
            "fax_number": "240-477-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC CENTER OF NORTHERN VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-11",
        "last_updated": "2025-07-09",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "ASTRADA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-868-9001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "740028400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Center of Northern Virginia, Chtd",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Psychiatric Center of Northern Virginia, Chtd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.