Individual provider Active NPI

Roshnee K Pennington, PA-C

  • Physician Assistant
  • Rockville, MD
National Provider Identifier
1508083759
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C02383 Issued in MD
Practice address
15001 Shady Grove Rd
Suite #110
Rockville, MD 20850-6352
Phone
(301) 251-9555
Fax
(301) 309-0765
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C02383 MD Primary

Addresses

Primary practice location

15001 Shady Grove Rd
Suite #110
Rockville, MD 20850-6352

Mailing address

15001 Shady Grove Rd
Suite #110
Rockville, MD 20850-6352
Phone (301) 251-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070719000365 DC Practitioner - Physician Assistant 7517068620 Reassigns benefits to 2 organizations
I20230607001904 MD Practitioner - Physician Assistant 7517068620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

13950 Brandywine Rd
Brandywine, MD 20613-5815
Phone (301) 782-2220

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

29955 Three Notch Rd
100 MMG at Charlotte Hall
Charlotte Hall, MD 20622-3159
Phone (301) 290-5300

3007 Tilden St NE
Suite 5N
Washington, DC 20008-3030

3007 Tilden St NW
Washington, DC 20008-3030

3062 Waldorf Market PL
MMG at 3062 Waldorf Market PL
Waldorf, MD 20603-4871
Phone (301) 782-2220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Oct 1, 2010 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jul 11, 2022 Accepting new patients
Children'S Hospital CurrentSince Oct 1, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3007 Tilden St NW
Ste 5N
Washington, DC 20008

Organizations & group practices 6

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508083759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15001 SHADY GROVE RD",
            "address_2": "SUITE #110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506352",
            "telephone_number": "301-251-9555",
            "fax_number": "301-309-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15001 SHADY GROVE RD",
            "address_2": "SUITE #110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506352",
            "telephone_number": "301-251-9555",
            "fax_number": "301-309-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "ROSHNEE",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C02383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.