Active NPI
Rcca MD LLC
- Hematology & Oncology Physician
- Rockville, MD
National Provider Identifier
1255894879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- Legal business name
- RCCA MD LLC
- Practice address
- 9715 Medical Center Dr Ste 221
Rockville, MD 20850-6319 - Phone
- (301) 774-6136
- NPI assigned
- Apr 10, 2019
- Last updated
- Apr 28, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Terrill Jordan
- Title
- Ceo
- Phone
- (201) 510-0910
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | NU | Primary |
Addresses
Primary practice location
9715 Medical Center Dr Ste 221
Rockville, MD 20850-6319
Mailing address
500 Frank W Burr Blvd
Suite 560 Mailbox 29
Teaneck, NJ 07666-6802
Phone (201) 510-0910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160711001213 | DC | Part B Supplier - Clinic/Group Practice | 8123310208 |
Receives reassigned benefits from 7 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chevy Chase, MD; Rockville, MD; Olney, MD; Clarksburg, MD |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Rcca MD LLC
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Hematology & Oncology Physician
- Clarksburg, MD
- NPI 1205680048
-
- Hematology & Oncology Physician
- Olney, MD
- NPI 1366009938
-
- Hematology & Oncology Physician
- Chevy Chase, MD
- NPI 1437903275
-
- Hematology & Oncology Physician
- Olney, MD
- NPI 1467800367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554854400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682640000000",
"number": "1255894879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 FRANK W BURR BLVD",
"address_2": "SUITE 560 MAILBOX 29",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076666802",
"telephone_number": "201-510-0910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9715 MEDICAL CENTER DR STE 221",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208506319",
"telephone_number": "301-774-6136"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RCCA MD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-04-10",
"last_updated": "2023-04-28",
"certification_date": "2023-04-28",
"status": "A",
"authorized_official_last_name": "JORDAN",
"authorized_official_first_name": "TERRILL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "201-510-0910",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.