Active NPI
Charles Raymond Privitera, M.D.
- Psychiatry Physician
- Bethesda, MD
National Provider Identifier
1134309727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- DO4498
- Practice address
- 4301 Jones Bridge Rd
A-1038
Bethesda, MD 20814-4712 - Phone
- (301) 295-9851
- Fax
- (301) 295-3100
- NPI assigned
- Nov 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | DO4498 | MD | Primary |
Addresses
Primary practice location
4301 Jones Bridge Rd
A-1038
Bethesda, MD 20814-4712
Mailing address
4301 Jones Bridge Rd
A-1038
Bethesda, MD 20814-4712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 22, 2014 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO4498 | MD | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194825600000",
"number": "1134309727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 JONES BRIDGE RD",
"address_2": "A-1038",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208144712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 JONES BRIDGE RD",
"address_2": "A-1038",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208144712",
"telephone_number": "301-295-9851",
"fax_number": "301-295-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIVITERA",
"first_name": "CHARLES",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-12",
"last_updated": "2007-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "DO4498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.