Active NPI
Mark Gregory Roddy, M.D.
- Pediatric Emergency Medicine (Pediatrics) Physician
- Rockville, MD
National Provider Identifier
1417998600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- D0060175
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 402444301 | Medicaid | MD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD34209 | DC | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Interoperability endpoints
- 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.