Individual provider Active NPI

Ladan Shayesteh, DO MPH

  • Family Medicine Physician
  • Chevy Chase, MD
National Provider Identifier
1477677045
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0057083 Issued in MD
Practice address
5530 Wisconsin Ave
#1149
Chevy Chase, MD 20815-4404
Phone
(240) 223-2639
Fax
(240) 223-3223
NPI assigned
Mar 19, 2007
Last updated
Apr 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0057083 MD Primary

Addresses

Primary practice location

5530 Wisconsin Ave
#1149
Chevy Chase, MD 20815-4404

Mailing address

5530 Wisconsin Ave
#1149 Contemporary Family Medicine Associates
Chevy Chase, MD 20815-4404
Phone (240) 223-2639

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 Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H0057083MDMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1477677045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE",
            "address_2": "#1149 CONTEMPORARY FAMILY MEDICINE ASSOCIATES",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154404",
            "telephone_number": "240-223-2639",
            "fax_number": "240-223-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE",
            "address_2": "#1149",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154404",
            "telephone_number": "240-223-2639",
            "fax_number": "240-223-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYESTEH",
        "first_name": "LADAN",
        "name_prefix": "Dr.",
        "credential": "DO MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0057083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.