Individual provider Active NPI

Lauren Sukri, PA

  • Physician Assistant
  • Bethesda, MD
National Provider Identifier
1164290656
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0009174 Issued in MD
Practice address
6410 Rockledge Dr Ste 402
Bethesda, MD 20817-7807
Phone
(443) 351-3376
NPI assigned
Dec 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0009174 MD Primary

Addresses

Primary practice location

6410 Rockledge Dr Ste 402
Bethesda, MD 20817-7807

Mailing address

1306 Concourse Dr Ste 201
Linthicum Heights, MD 21090-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240423000717 MD Practitioner - Physician Assistant 2466891544 Reassigns benefits to 1 organization
I20240423000853 DC Practitioner - Physician Assistant 2466891544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anne Arundel Dermatology PAGroup PAC ID 6608761960, 126 clinicians

Practice addresses (Care Compare)

6410 Rockledge Dr
Suite 300
Bethesda, MD 20817-7811
Phone (301) 564-3131

6410 Rockledge Dr
Suite 402
Bethesda, MD 20817-7807
Phone (301) 530-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0009174MDMDPhysician Assistant

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": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1164290656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 CONCOURSE DR STE 201",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210901033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR STE 402",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177807",
            "telephone_number": "443-351-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKRI",
        "first_name": "LAUREN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.