Individual provider Active NPI

Vitu Van, MD

  • Family Medicine Physician
  • JB Andrews, MD
National Provider Identifier
1174013866
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0093030 Issued in MD
Practice address
1060 W Perimeter Rd
JB Andrews, MD 20762-6602
Phone
(240) 612-2567
NPI assigned
May 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0093030 MD Primary

Addresses

Primary practice location

1060 W Perimeter Rd
JB Andrews, MD 20762-6602

Mailing address

1060 W Perimeter Rd
JB Andrews, MD 20762-6602
Phone (240) 612-0234

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220208001978 MD Practitioner - Family Practice 9436542867 Reassigns benefits to 3 organizations
I20231007000839 DC Practitioner - Family Practice 9436542867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

3064 Waldorf Market PL
Waldorf, MD 20603-4871
Phone (301) 932-5960

500 Charles St
La Plata, MD 20646-5931
Phone (410) 451-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0093030MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care, LLC CurrentSince Sep 24, 2023 Accepting new patients
University of Maryland Family Medicine Associates, P.a. CurrentSince Feb 1, 2022 Accepting new patients
Medstar Urgent Care LLC Current Accepting new patients
University of Maryland Family Medicine Associates, P.a. CurrentSince Feb 1, 2022 Accepting new patients
Medstar Urgent Care LLC CurrentSince Sep 24, 2023 Accepting new patients
University of Maryland Faculty Physicians Immediate Care, LLC CurrentSince Feb 1, 2022 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1805 Columbia Rd NW
Washington, DC 20009
Phone (202) 797-4950

3007 Tilden St NW
Ste 5N
Washington, DC 20008

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

5890 Waterloo Rd
Columbia, MD 21045
Phone (410) 328-2603

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

Organizations & group practices 7

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": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1174013866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "240-612-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "240-612-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "VITU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-17",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0093030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in JB Andrews, MD

Sources for this page

Verify at the official NPI Registry.