Organization Active NPI

Peter a Swaby DO LLC

  • Internal Medicine Physician
  • Bowie, MD
National Provider Identifier
1417081043
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H0052843 Issued in MD
Legal business name
PETER A SWABY DO LLC
Practice address
4000 Mitchellville Rd
Suite 422
Bowie, MD 20716-3104
Phone
(301) 809-6206
Fax
(301) 809-6225
NPI assigned
Mar 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Eno Y Inyangswaby, HEALTH ADMIN
Title
Office Manager
Phone
(301) 809-6206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H0052843 MD Primary

Addresses

Primary practice location

4000 Mitchellville Rd
Suite 422
Bowie, MD 20716-3104

Mailing address

4000 Mitchellville Rd
Suite 422
Bowie, MD 20716-3104
Phone (301) 809-6206

Other identifiers 1

IdentifierTypeStateIssuer
698302200MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120726000088 DC Part B Supplier - Clinic/Group Practice 6709042385 Receives reassigned benefits from 2 practitioners
Practice locations: Bowie, MD

National Provider Directory

National Provider Directory

Locations

3038 Mitchellville Rd
Ste 104
Bowie, MD 20716
Phone (301) 809-6206

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417081043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "SUITE 422",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-809-6206",
            "fax_number": "301-809-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "SUITE 422",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-809-6206",
            "fax_number": "301-809-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER A SWABY DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "INYANGSWABY",
        "authorized_official_first_name": "ENO",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-809-6206",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "HEALTH ADMIN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H0052843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "698302200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.