Premier Allergy and Asthma Centers, LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

PREMIER ALLERGY AND ASTHMA CENTERS, LLC

Practice address

8100 Ashton Ave Ste 207B
Manassas, VA 20109-5688

Phone

(855) 528-7348

Fax

(855) 329-2873

NPI assigned

May 19, 2020

Last updated

May 19, 2020By 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

Dr. Petr Bocek, MD, PHDNPI 1790998458

Title

Ceo

Phone

(855) 528-7348

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Petr Bocek, MD, PHD

  • Allergy & Immunology Physician
  • Manassas, VA
  • NPI 1790998458

  DC, Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1255954764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20236 MCNAMARA RD",
            "city": "POOLESVILLE",
            "state": "MD",
            "postal_code": "208379418",
            "telephone_number": "855-528-7348",
            "fax_number": "855-329-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE STE 207B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095688",
            "telephone_number": "855-528-7348",
            "fax_number": "855-329-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ALLERGY AND ASTHMA CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "BOCEK",
        "authorized_official_first_name": "PETR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-528-7348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Allergy & Immunology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.

Verify at the official NPI Registry.