Individual provider Active NPI

Mark Gregory Roddy, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Rockville, MD
National Provider Identifier
1417998600
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
D0060175 Issued in MD
Practice address
12254 Rockville Pike
Rockville, MD 20852-1608
Phone
(301) 230-2767
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 0101265385 VA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X MD600005786 DC
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X D0060175 MD Primary

Addresses

Primary practice location

12254 Rockville Pike
Rockville, MD 20852-1608

Mailing address

5906 Oxford Rd
Glen Echo, MD 20812-1204
Phone (301) 263-1110

Other practice location 1

3100 14th St NW
Washington, DC 20010-2415
Phone (202) 921-6767

Other identifiers 1

IdentifierTypeStateIssuer
402444301MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD34209DCMDPediatric Emergency Medicine (Pediatrics) Physician

Interoperability endpoints

  • Direct secure messaging: mark.roddy@pmuc.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1417998600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5906 OXFORD RD",
            "city": "GLEN ECHO",
            "state": "MD",
            "postal_code": "208121204",
            "telephone_number": "301-263-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12254 ROCKVILLE PIKE",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208521608",
            "telephone_number": "301-230-2767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 14th St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102415",
            "country_code": "US",
            "telephone_number": "202-921-6767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODDY",
        "first_name": "MARK",
        "middle_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "VA",
            "license": "0101265385",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "DC",
            "license": "MD600005786",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MD",
            "license": "D0060175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402444301",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.