Brenda Lee Pellicane, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD0075639 Issued in MD

Practice address

11300 Rockville Pike Ste 911
North Bethesda, MD 20852-3034

Phone

(301) 810-3600

Fax

(313) 429-7931

NPI assigned

Feb 18, 2007

Last updated

Oct 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Brenda Lee Bartlett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1457495848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 ROCKVILLE PIKE STE 911",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523034",
            "telephone_number": "301-810-3600",
            "fax_number": "313-429-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 ROCKVILLE PIKE STE 911",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523034",
            "telephone_number": "301-810-3600",
            "fax_number": "313-429-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICANE",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "MD0075639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "BARTLETT",
            "middle_name": "LEE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yutaka Okamoto, D.D.S.
• Orthobiologics Research Initiative, Inc.
• Jihye Park
• Kashiben G Patel, MD
• Peach State Medical Practice, PC (Kindbody of MD Medical Practice)
• Peony Womens Integrative Health LLC
• Lidya Daniella Perez Simon, DMD
• Leanne Marie Perez
• Person Clinic LLC
• Rachel Pittmann, M.S. CCC-SLP

• Dermatology Physician in North Bethesda, MD
• Providers in North Bethesda, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.