Medstar Medical Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MEDSTAR MEDICAL GROUP, LLC

Practice address

2021 K St NW
Suite 310
Washington, DC 20006-1003

Phone

(202) 429-2401

Fax

(202) 429-4341

NPI assigned

Nov 21, 2011

Last updated

Feb 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric R. Wagner

Title

Executive Vice President

Phone

(410) 772-6595

Specialties & licenses 1

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa Grace Blumgart, AU.D.

  • Audiologist
  • Washington, DC
  • NPI 1124680681
  NPD (past)
• Kelsey Mansley, PA-C

  • Physician Assistant
  • Washington, DC
  • NPI 1134644412
  NPD (past)
• Katherine Hamilton, M.D.

  • Neurology Physician
  • Chevy Chase, MD
  • NPI 1558603027
  NPD (past)
• Jane Oh, PA-C

  • Physician Assistant
  • Galveston, TX
  • NPI 1093523862
  NPD (past)
• Luciana Lera de Almeida Veiga, MD

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1285897322
  NPD (past)

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1255608139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8094 SANDPIPER CIR",
            "address_2": "SUITE O",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364907",
            "telephone_number": "410-933-3017",
            "fax_number": "410-933-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 K ST NW",
            "address_2": "SUITE 310",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061003",
            "telephone_number": "202-429-2401",
            "fax_number": "202-429-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "410-772-6595"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medstar Medical Group II LLC
• Medstar Medical Group II LLC
• Medstar Medical Group Radiology, LLC
• Medstar Medical Group Radiology, LLC
• Medstar Medical Group Radiology, LLC
• Medstar National Rehabilitation Hospital (Medstar National Rehabilitation Hospital Pharmacy)
• Medstar National Rehabilitation Network
• Medstar Pharmacies Inc (MedStar Pharmacy at Georgetown University Hospital)
• Medstar Pharmacies, Inc.
• Medstar Surgery Center at Lafayette Centre, LLC

• Internal Medicine Physician in Washington, DC
• Providers in Washington, DC by specialty
• Internal Medicine Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.