Individual provider Active NPI

Guy David Prosper, MD

  • Pediatrics Physician
  • Falls Church, VA
National Provider Identifier
1164827762
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101260176 Issued in VA
Practice address
6565 Arlington Blvd Ste 210
Falls Church, VA 22042-3000
Phone
(703) 534-1000
NPI assigned
Oct 27, 2014
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0092938 MD
Pediatrics Physician 208000000X 0101260176 VA Primary

Addresses

Primary practice location

6565 Arlington Blvd Ste 210
Falls Church, VA 22042-3000

Mailing address

9203C Forest Haven Dr
Alexandria, VA 22309-3202
Phone (301) 351-4191

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-6545

Other practice location 2

234 E 149th St
Bronx, NY 10451-5504
Phone (301) 351-4191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230104002759 DC Practitioner - HospitalistPractitioner - Pediatric Medicine 0345610549 Reassigns benefits to 1 organization
I20231121004043 MD Practitioner - Pediatric Medicine 0345610549 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0092938MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. Pediatrics CurrentSince Aug 22, 2023 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Aug 22, 2023 Accepting new patients
Inova Health Care Services CurrentSince Oct 1, 2022 Accepting new patients
Inova Health Care Services Pediatrics CurrentSince Oct 1, 2022 Accepting new patients
Baltimore Washington Emergency Physicians, Inc. Past Accepting new patients
Capital Area Pediatrics, Inc Pediatrics Past Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

6565 Arlington Blvd
Ste 210
Falls Church, VA 22042
Phone (703) 534-1000

Interoperability endpoints

  • Direct secure messaging: gprosper1031651@direct.umm.edu
  • Direct secure messaging: guy.prosper.1@16203.direct.athenahealth.com

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1164827762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9203C FOREST HAVEN DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223093202",
            "telephone_number": "301-351-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 ARLINGTON BLVD STE 210",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423000",
            "telephone_number": "703-534-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-6545",
            "fax_number": "703-776-4323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234 E 149th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104515504",
            "country_code": "US",
            "telephone_number": "301-351-4191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROSPER",
        "first_name": "GUY",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-27",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0092938",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101260176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.