NPIMap

Organization Active NPI

Medstar Health at Brandywine

  • Family Medicine Physician
  • Brandywine, MD
National Provider Identifier
1124474507
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDSTAR HEALTH AT BRANDYWINE
Practice address
13950 Brandywine Rd
Suite 125
Brandywine, MD 20613-5815
Phone
(301) 782-2220
Fax
(301) 782-2221
NPI assigned
May 4, 2016
Organization subpart
Yes
Parent organization
MEDSTAR AMBULATORY SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Authorized official

Name
Judy L Sylvester
Title
Director of Finance and Billing
Phone
(301) 877-4564

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X

Addresses

Primary practice location

13950 Brandywine Rd
Suite 125
Brandywine, MD 20613-5815

Mailing address

13950 Brandywine Rd
Suite 125
Brandywine, MD 20613-5815
Phone (301) 782-2220

Other names 1

  • MedStar Health at Brandywine / Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medstar Health at Brandywine2 organizations share this tax ID, including this one
Part of
Medstar Health at Brandywine

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1124474507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13950 BRANDYWINE RD",
            "address_2": "SUITE 125",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206135815",
            "telephone_number": "301-782-2220",
            "fax_number": "301-782-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 BRANDYWINE RD",
            "address_2": "SUITE 125",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206135815",
            "telephone_number": "301-782-2220",
            "fax_number": "301-782-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR HEALTH AT BRANDYWINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDSTAR AMBULATORY SERVICES, INC.",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "SYLVESTER",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE AND BILLING",
        "authorized_official_telephone_number": "301-877-4564"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedStar Health at Brandywine / Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandywine, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.