Organization Active NPI

Bethesda Medical Associates

  • Internal Medicine Physician
  • Bethesda, MD
National Provider Identifier
1447560016
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BETHESDA MEDICAL ASSOCIATES
Practice address
10215 Fernwood Rd Ste 50
Bethesda, MD 20817-1174
Phone
(301) 493-9320
Fax
(301) 439-5532
NPI assigned
Oct 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Authorized official

Name
Mrs. Amber Blackwell, RN, BSN, CMPE
Title
Practice Administrator
Phone
(301) 493-9320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

10215 Fernwood Rd Ste 50
Bethesda, MD 20817-1174

Mailing address

10215 Fernwood Road Suite 100a
Bethesda, MD 20817
Phone (301) 493-9607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110302000802 DC Part B Supplier - Clinic/Group Practice 9537341128 Receives reassigned benefits from 8 practitioners
Practice locations: Bethesda, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2017746Bethesda Medical Associates PC10215 Fernwood Road Suite 50, Bethesda, MD 20817Certificate of waiverDec 16, 2026

National Provider Directory

National Provider Directory

Locations

10215 Fernwood Rd
Ste 50
Bethesda, MD 20817
Phone (301) 493-9607

10215 Fernwood Rd
Ste 100A
Bethesda, MD 20817

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13741/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1447560016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 FERNWOOD ROAD SUITE 100A",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20817",
            "telephone_number": "301-493-9607",
            "fax_number": "301-439-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 FERNWOOD RD STE 50",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171174",
            "telephone_number": "301-493-9320",
            "fax_number": "301-439-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "301-493-9320",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, BSN, CMPE"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.