Individual provider Active NPI

Mary Beth Alder, RN , BSN, NP, DNSC

  • Nurse Practitioner
  • Washington, DC
National Provider Identifier
1548450463
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN1015562 Issued in DC
Practice address
1140 Varnum St NE Ste 203
Washington, DC 20017-2153
Phone
(202) 525-5175
Fax
(202) 450-6088
NPI assigned
Jul 26, 2007
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 0001096719 VA
Nurse Practitioner 363L00000X RN1015562 DC Primary

Addresses

Primary practice location

1140 Varnum St NE Ste 203
Washington, DC 20017-2153

Mailing address

1140 Varnum St NE Ste 203
Washington, DC 20017-2153
Phone (202) 525-5175

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201110001819 DC Practitioner - Nurse Practitioner 7214347863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Health InstituteGroup PAC ID 1456696368, 18 clinicians

Practice addresses (Care Compare)

1140 Varnum St NE
Suite 203
Washington, DC 20017-2153
Phone (240) 426-8890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001096719VAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Health Institute Infectious Disease CurrentSince Feb 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1140 Varnum St NE
Washington, DC 20017
Phone (202) 269-6484

1140 Varnum St NE
Ste 203
Washington, DC 20017
Phone (202) 525-5175

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADDGCD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1548450463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 VARNUM ST NE STE 203",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172153",
            "telephone_number": "202-525-5175",
            "fax_number": "202-450-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 VARNUM ST NE STE 203",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172153",
            "telephone_number": "202-525-5175",
            "fax_number": "202-450-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDER",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "RN , BSN, NP, DNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0001096719",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "RN1015562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.