Individual provider Active NPI

Carlos Julio Molestina, PA-C

  • Surgical Physician Assistant
  • Cheverly, MD
National Provider Identifier
1194109983
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C0005810 Issued in MD
Practice address
3001 Hospital Dr
Cheverly, MD 20785-1189
Phone
(301) 618-2000
NPI assigned
Jul 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0005810 MD
Surgical Physician Assistant 363AS0400X C0005810 MD Primary

Addresses

Primary practice location

3001 Hospital Dr
Cheverly, MD 20785-1189

Mailing address

1573 N Colonial Ter
Unit 202
Arlington, VA 22209-1422
Phone (571) 418-8347

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200529002453 DC Practitioner - Physician Assistant 6800217829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2900 Mercy LN
Cheverly, MD 20785-1157
Phone (301) 618-2273

901 Harry S Truman Dr N
Upper Marlboro, MD 20774-5477
Phone (240) 677-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C0005810MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dimensions Healthcare Associates Inc CurrentSince Mar 1, 2020 Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Mar 1, 2020 Accepting new patients

Locations

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1194109983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 N COLONIAL TER",
            "address_2": "UNIT 202",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222091422",
            "telephone_number": "571-418-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "301-618-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLESTINA",
        "first_name": "CARLOS",
        "middle_name": "JULIO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005810",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0005810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheverly, MD

Sources for this page

Verify at the official NPI Registry.