Individual provider Active NPI

John Wycliff Bedeau, M.D.

  • Gastroenterology Physician
  • Largo, MD
National Provider Identifier
1487646154
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
D30666 Issued in MD
Practice address
9301 Largo Drive West
Suite 201
Largo, MD 20774-4884
Phone
(301) 350-8722
Fax
(301) 350-8822
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D30666 MD Primary

Addresses

Primary practice location

9301 Largo Drive West
Suite 201
Largo, MD 20774-4884

Mailing address

9301 Largo Dr W Ste 201
Largo, MD 20774-4884
Phone (301) 350-8722

Other identifiers 2

IdentifierTypeStateIssuer
025110100MedicaidDC
37808-1300MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081010000559 DC Practitioner - GastroenterologyPractitioner - Internal Medicine 5890869663 Reassigns benefits to 1 organization
Practice locations: Largo, MD

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1979
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9301 Largo Dr W
Suite 201
Largo, MD 20774-4884
Phone (301) 350-8722

Hospital & facility affiliations

  • Luminis Health Doctors Community Medical Ctr, Inc Hospital, Lanham, MD, CCN 210051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy171
Upper gastrointestinal (GI) endoscopy for acid reflux70

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D30666MDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John W Bedeau, MD PC Gastroenterology CurrentSince Jul 10, 1985 Accepting new patients
East Coast Gastroenterology LLC Gastroenterology Past Accepting new patients
Rockville Ambulatory Surgery, LP PastSince Apr 28, 2009 Accepting new patients

Locations

9301 Largo Dr W
Ste 201
Largo, MD 20774
Phone (301) 350-8722

Interoperability endpoints

  • Direct secure messaging: jbedeau801426@direct.umm.edu

Organizations & group practices 3

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

Hospital & facility affiliations 1

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1487646154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 LARGO DR W STE 201",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744884",
            "telephone_number": "301-350-8722",
            "fax_number": "301-350-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 LARGO DRIVE WEST",
            "address_2": "SUITE 201",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744884",
            "telephone_number": "301-350-8722",
            "fax_number": "301-350-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDEAU",
        "first_name": "JOHN",
        "middle_name": "WYCLIFF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D30666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025110100",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37808-1300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.