NPIMap

Organization Active NPI

Marcellus R Cephas MD LLC

  • Psychiatry Physician
  • Takoma PK, MD
National Provider Identifier
1366579013
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D00595532 Issued in MD
Legal business name
MARCELLUS R CEPHAS MD LLC
Practice address
7610 Carroll Ave
Suite 200
Takoma PK, MD 20912
Phone
(301) 891-2077
Fax
(301) 891-2080
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Authorized official

Name
Mr. Marcellus R Cephas, MDNPI 1134116007
Title
Owner/MD
Phone
(301) 891-2077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X D00595532 MD
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X D00595532 MD Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 207888-1 MD

Addresses

Primary practice location

7610 Carroll Ave
Suite 200
Takoma PK, MD 20912

Mailing address

7610 Carroll Ave
Suite 200
Takoma Park, MD 20912-6384
Phone (301) 891-2077

Other identifiers 2

IdentifierTypeStateIssuer
H022891MedicaidMD
4022891MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120229000495 DC Part B Supplier - Clinic/Group Practice 9638337132 Receives reassigned benefits from 4 practitioners
Practice locations: Takoma Park, MD

National Provider Directory

National Provider Directory
Tax ID family
Marcellus R Cephas MD LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1366579013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 CARROLL AVE",
            "address_2": "SUITE 200",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209126384",
            "telephone_number": "301-891-2077",
            "fax_number": "301-891-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 CARROLL AVE",
            "address_2": "SUITE 200",
            "city": "TAKOMA PK",
            "state": "MD",
            "postal_code": "20912",
            "telephone_number": "301-891-2077",
            "fax_number": "301-891-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCELLUS R CEPHAS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "CEPHAS",
        "authorized_official_first_name": "MARCELLUS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "301-891-2077",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MD",
            "license": "D00595532",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D00595532",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "207888-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H022891",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4022891",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; 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.