Individual provider Active NPI

Roger Stevenson Jr., M.D.

  • Cardiovascular Disease Physician
  • Bethesda, MD
National Provider Identifier
1255336525
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
D0020535 Issued in MD
Practice address
6410 Rockledge Dr
Ste 200
Bethesda, MD 20817-1830
Phone
(301) 897-5301
Fax
(301) 564-4289
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X D0020535 MD Primary

Addresses

Primary practice location

6410 Rockledge Dr
Ste 200
Bethesda, MD 20817-1830

Mailing address

11808 Hunting Ridge CT
Potomac, MD 20854-2151

Other identifiers 5

IdentifierTypeStateIssuer
22168OtherMDMDIPA
493860OtherMDNCPPO
122018OtherMDAETNA
308911800MedicaidMD
12470003OtherMDBCBS

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
I20100902000749 DC Practitioner - Cardiovascular Disease (Cardiology) 7517081151 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0020535MDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc CurrentSince Jan 1, 2012 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Jan 1, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Adventist Healthcare, Inc. Cardiovascular Disease Past Accepting new patients

Locations

6410 Rockledge Dr
Ste 200
Bethesda, MD 20817
Phone (301) 897-5301

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

10313 Georgia Ave
Ste 307
Silver Spring, MD 20902
Phone (301) 681-9095

Organizations & group practices 5

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1255336525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11808 HUNTING RIDGE CT",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR",
            "address_2": "STE 200",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171830",
            "telephone_number": "301-897-5301",
            "fax_number": "301-564-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D0020535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "22168",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "493860",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "122018",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308911800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12470003",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.