Individual provider Active NPI

Janice Evelyn Vasquez, CRNP

  • Pediatric Nurse Practitioner
  • Silver Spring, MD
National Provider Identifier
1417408022
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R185883 Issued in MD
Practice address
1500 Forest Glen Rd
Silver Spring, MD 20910-1460
Phone
(301) 754-3400
NPI assigned
Oct 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R185883 MD Primary

Addresses

Primary practice location

1500 Forest Glen Rd
Silver Spring, MD 20910-1460

Mailing address

1500 Forest Glen Rd
Silver Spring, MD 20910-1460

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
I20170110002097 DC Practitioner - Nurse Practitioner 4486935251 Reassigns benefits to 1 organization
I20201113001396 MD Practitioner - Nurse Practitioner 4486935251 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R185883MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Health, LLC CurrentSince Dec 1, 2016 Accepting new patients
International Pediatrics, P a Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

Organizations & group practices 3

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": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1417408022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 FOREST GLEN RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 FOREST GLEN RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101460",
            "telephone_number": "301-754-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JANICE",
        "middle_name": "EVELYN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R185883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.