Individual provider Active NPI

Bertha Cecilia Velandia Rubiano, MD

  • Family Medicine Physician
  • Gaithersburg, MD
National Provider Identifier
1295945830
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0077073 Issued in MD
Practice address
800 S Frederick Ave Ste 110
Gaithersburg, MD 20877-4151
Phone
(301) 208-2273
Fax
(855) 313-1249
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44974 TN
Family Medicine Physician 207Q00000X D0077073 MD Primary

Addresses

Primary practice location

800 S Frederick Ave Ste 110
Gaithersburg, MD 20877-4151

Mailing address

10801 Lockwood Dr Ste 160
Silver Spring, MD 20901-1586
Phone (301) 298-1040

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
I20210720002465 DC Practitioner - Family Practice 2163565417 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0077073MDMDFamily Medicine Physician
44974TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Care Center LLC CurrentSince Jan 1, 2022 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince Jul 1, 2021 Accepting new patients
Privia Care Center LLC CurrentSince Jan 1, 2022 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Kessous & Kessous MD PC Past Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

10801 Lockwood Dr
Ste 160
Silver Spring, MD 20901
Phone (301) 298-1040

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • Direct secure messaging: bertha.velandia.rubiano.1@15259.direct.athenahealth.com

Organizations & group practices 6

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1295945830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 LOCKWOOD DR STE 160",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011586",
            "telephone_number": "301-298-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S FREDERICK AVE STE 110",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774151",
            "telephone_number": "301-208-2273",
            "fax_number": "855-313-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELANDIA RUBIANO",
        "first_name": "BERTHA",
        "middle_name": "CECILIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "44974",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0077073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.