Individual provider Active NPI

Christine Briccetti, MD

  • Pediatrics Physician
  • Washington, DC
National Provider Identifier
1184696908
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
041365 Issued in CT
Practice address
111 Michigan Ave NW
Washington, DC 20010-2916
Phone
(301) 372-1323
Fax
(860) 545-9301
NPI assigned
Feb 6, 2006
Last updated
Oct 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 041365 CT Primary

Addresses

Primary practice location

111 Michigan Ave NW
Washington, DC 20010-2916

Mailing address

PO Box 37215
Baltimore, MD 21297-3215

Other identifiers 1

IdentifierTypeStateIssuer
001413658MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121016000411 DC Practitioner - Pediatric Medicine 7517937212 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041365CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince Sep 19, 2012 Accepting new patients
Children's Hospital Pediatrics CurrentSince Sep 19, 2012 Accepting new patients
Children's Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

Organizations & group practices 3

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1184696908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37215",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "301-372-1323",
            "fax_number": "860-545-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICCETTI",
        "first_name": "CHRISTINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "041365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001413658",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.