Active NPI
Anthony Faugeres Emmanuel
- Surgical Physician Assistant
- Bethesda, MD
National Provider Identifier
1497069249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- CERTIFIED ASSISTANT
- Practice address
- 6400 Goldsboro Road Suite 400
Massachusetts Ave Surgery Center
Bethesda, MD 20817 - Phone
- (301) 263-0800
- Fax
- (301) 263-8020
- NPI assigned
- Aug 4, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | CERTIFIED ASSISTANT | VA | Primary |
Addresses
Primary practice location
6400 Goldsboro Road Suite 400
Massachusetts Ave Surgery Center
Bethesda, MD 20817
Mailing address
9720 Leatherfern Ter
Apt 101
Montgomery Village, MD 20886-6330
Phone (301) 642-1304
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CERTIFIED ASSISTANT | VA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280880000000",
"number": "1497069249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9720 LEATHERFERN TER",
"address_2": "APT 101",
"city": "MONTGOMERY VILLAGE",
"state": "MD",
"postal_code": "208866330",
"telephone_number": "301-642-1304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 GOLDSBORO ROAD SUITE 400",
"address_2": "MASSACHUSETTS AVE SURGERY CENTER",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20817",
"telephone_number": "301-263-0800",
"fax_number": "301-263-8020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMMANUEL",
"first_name": "ANTHONY",
"middle_name": "FAUGERES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-04",
"last_updated": "2010-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "VA",
"license": "CERTIFIED ASSISTANT",
"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 Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.