Individual provider Active NPI

Neeraj Harry, PA-C

  • Surgical Physician Assistant
  • Olney, MD
National Provider Identifier
1386920007
Registry record updated Jan 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C0004687 Issued in MD
Practice address
3414 Olandwood CT
Olney, MD 20832-1384
Phone
(301) 774-0500
Fax
(301) 774-7338
NPI assigned
Oct 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C0004687 MD Primary
Medical Physician Assistant 363AM0700X C0004687 MD

Addresses

Primary practice location

3414 Olandwood CT
Olney, MD 20832-1384

Mailing address

3414 Olandwood CT
Olney, MD 20832-1384
Phone (301) 774-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120423000226 DC Practitioner - Physician Assistant 9739340589 Reassigns benefits to 2 organizations
I20151006000526 MD Practitioner - Physician Assistant 9739340589 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0004687MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Oct 5, 2015 Accepting new patients
Advanced Pain Medicine Institute, PC CurrentSince Mar 17, 2012 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Oct 5, 2015 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Oct 5, 2015 Accepting new patients
Advanced Pain Medicine Institute, PC CurrentSince Mar 17, 2012 Accepting new patients

Locations

5530 Wisconsin Ave
Ste 1550
Chevy Chase, MD 20815
Phone (301) 345-8835

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

7500 Greenway Center Dr
Ste 520
Greenbelt, MD 20770
Phone (301) 220-1333

3414 Olandwood Ct
Olney, MD 20832
Phone (301) 774-0500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11237/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452297600000",
    "number": "1386920007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 OLANDWOOD CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321384",
            "telephone_number": "301-774-0500",
            "fax_number": "301-774-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 OLANDWOOD CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321384",
            "telephone_number": "301-774-0500",
            "fax_number": "301-774-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRY",
        "first_name": "NEERAJ",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2016-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0004687",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004687",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.