NPIMap

Individual provider Active NPI

Nadine Ziad Idriss

  • Pediatrics Physician
  • Bethesda, MD
National Provider Identifier
1295995991
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0067948 Issued in MD
Practice address
5301 Westbard Cir
Suite 3
Bethesda, MD 20816-1401
Phone
(301) 654-6303
Fax
(301) 654-6304
NPI assigned
Jun 16, 2008
Last updated
Apr 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0067948 MD Primary

Addresses

Primary practice location

5301 Westbard Cir
Suite 3
Bethesda, MD 20816-1401

Mailing address

5301 Westbard Cir
Suite 3
Bethesda, MD 20816-1401
Phone (301) 654-6303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0067948MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Kenwood Pediatrics, LLC Pediatrics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1295995991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 WESTBARD CIR",
            "address_2": "SUITE 3",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208161401",
            "telephone_number": "301-654-6303",
            "fax_number": "301-654-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 WESTBARD CIR",
            "address_2": "SUITE 3",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208161401",
            "telephone_number": "301-654-6303",
            "fax_number": "301-654-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRISS",
        "first_name": "NADINE",
        "middle_name": "ZIAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0067948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.