Individual provider Active NPI

Rebat Halder, MD

  • Dermatology Physician
  • Washington, DC
National Provider Identifier
1144265349
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD11882 Issued in DC
Practice address
2041 Georgia Ave NW
Washington, DC 20060-0001
Phone
(202) 865-6725
Fax
(202) 865-1757
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD11882 DC Primary

Addresses

Primary practice location

2041 Georgia Ave NW
Washington, DC 20060-0001

Mailing address

2024 Georgia Ave NW
Washington, DC 20001-3027
Phone (202) 865-3415

Other identifiers 1

IdentifierTypeStateIssuer
05902665MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD11882DCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Faculty Associates, Inc Dermatology Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1144265349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 GEORGIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200013027",
            "telephone_number": "202-865-3415",
            "fax_number": "202-865-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001",
            "telephone_number": "202-865-6725",
            "fax_number": "202-865-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALDER",
        "first_name": "REBAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "DC",
            "license": "MD11882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05902665",
            "state": "VA"
        }
    ],
    "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 Aug 20, 2007; 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.