NPIMap

Individual provider Active NPI

John P Tabacco, M.D.

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1437443330
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD047655 Issued in DC
Practice address
5215 Loughboro Rd NW Ste 440
Washington, DC 20016-2627
Phone
(202) 237-2912
NPI assigned
Jun 8, 2011
Last updated
Nov 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME116667 FL
Internal Medicine Physician 207R00000X 0101256150 VA
Sports Medicine (Internal Medicine) Physician 207RS0010X 0101256150 VA
Student in an Organized Health Care Education/Training Program 390200000X MD
Internal Medicine Physician 207R00000X MD047655 DC Primary

Addresses

Primary practice location

5215 Loughboro Rd NW Ste 440
Washington, DC 20016-2627

Mailing address

5215 Loughboro Rd NW Ste 440
Washington, DC 20016-2627
Phone (202) 237-2912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140919000411 DC Practitioner - Sports Medicine 8224267489 Reassigns benefits to 2 organizations
I20141007002687 VA Practitioner - Internal Medicine 8224267489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Potomac Internists, P.C.Group PAC ID 9032383518, 3 clinicians

Practice addresses (Care Compare)

5215 Loughboro Rd NW
Suite 440
Washington, DC 20016-2627
Phone (202) 237-2912

6410 Rockledge Dr
Bethesda, MD 20817-1844

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD047655DCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Jul 9, 2014 Accepting new patients
Potomac Internists, P.C. Internal Medicine CurrentSince Dec 20, 2021 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 9, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5215 Loughboro Rd NW
Washington, DC 20016
Phone (202) 537-4400

5215 Loughboro Rd NW
Ste 440
Washington, DC 20016
Phone (202) 237-2911

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

500 W Annandale Rd
Falls Church, VA 22046
Phone (703) 521-6662

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • Direct secure messaging: john.tabacco.1@33502.direct.athenahealth.com
  • Direct secure messaging: jtabacco921774@direct.hopkinsmedicine.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1437443330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 LOUGHBORO RD NW STE 440",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162627",
            "telephone_number": "202-237-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 LOUGHBORO RD NW STE 440",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162627",
            "telephone_number": "202-237-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABACCO",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-08",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME116667",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101256150",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "VA",
            "license": "0101256150",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD047655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.