NPIMap

Organization Active NPI

Brain Modulation Services, LLC

  • Psychiatry Physician
  • Chevy Chase, MD
National Provider Identifier
1609409150
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BRAIN MODULATION SERVICES, LLC
Practice address
5480 Wisconsin Ave Ste 223
Chevy Chase, MD 20815-3503
Phone
(301) 576-6044
Fax
(301) 576-1645
NPI assigned
Feb 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Gonzalo Laje, MDNPI 1750501516
Title
Director
Phone
(301) 576-6044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5480 Wisconsin Ave Ste 223
Chevy Chase, MD 20815-3503

Mailing address

5480 Wisconsin Ave Ste 223
Chevy Chase, MD 20815-3503
Phone (301) 576-6044

National Provider Directory

National Provider Directory

Locations

5480 Wisconsin Ave
Ste 223
Chevy Chase, MD 20815
Phone (301) 455-4149

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1609409150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE STE 223",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153503",
            "telephone_number": "301-576-6044",
            "fax_number": "301-576-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE STE 223",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153503",
            "telephone_number": "301-576-6044",
            "fax_number": "301-576-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN MODULATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "LAJE",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-576-6044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "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 Feb 12, 2020; 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.