Individual provider Active NPI

Evonne Greenidge

  • Pediatric Anesthesiology Physician
  • Washington, DC
National Provider Identifier
1417100595
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
MD040570 Issued in DC
Practice address
111 Michigan Ave NW
Washington, DC 20010-2916
Phone
(202) 476-2025
NPI assigned
Nov 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X MD040570 DC Primary

Addresses

Primary practice location

111 Michigan Ave NW
Washington, DC 20010-2916

Mailing address

PO Box 37215
Baltimore, MD 21297
Phone (202) 476-2025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20120726000589 DC Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 2961668488 Reassigns benefits to 6 organizations
I20200128002588 VA Practitioner - Anesthesiology 2961668488 Reassigns benefits to 2 organizations
I20260613000095 MD Practitioner - Anesthesiology 2961668488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pediatric Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1133 21St St NW
Medstar at Lafayette Centre
Washington, DC 20036-3390
Phone (202) 416-2000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC CurrentSince Jun 1, 2021 Accepting new patients
Children'S Hospital Current Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Jan 1, 2023 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Jun 1, 2021 Accepting new patients
Children'S Hospital CurrentSince Jul 1, 2012 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Jan 1, 2023 Accepting new patients
Anesthesia Connections-Virginia, LLC CurrentSince Dec 1, 2019 Accepting new patients
Medical Faculty Associates, Inc CurrentSince Jan 7, 2022 Accepting new patients
Children'S Hospital CurrentSince Jul 1, 2012 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

1133 21st St NW
Washington, DC 20036
Phone (202) 223-9040

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

5215 Monticello Ave
Williamsburg, VA 23188
Phone (757) 229-4000

Organizations & group practices 12

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": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1417100595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37215",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21297",
            "telephone_number": "202-476-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENIDGE",
        "first_name": "EVONNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "DC",
            "license": "MD040570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.