Organization Active NPI

Olney Medical Associates

  • Internal Medicine Physician
  • Olney, MD
National Provider Identifier
1609967736
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OLNEY MEDICAL ASSOCIATES
Practice address
18109 Prince Philip Dr Ste 275
Olney, MD 20832-1576
Phone
(301) 774-5400
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Rebecca E Colon
Title
Office Manager
Phone
(301) 774-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MD Primary

Addresses

Primary practice location

18109 Prince Philip Dr Ste 275
Olney, MD 20832-1576

Mailing address

18213 Hillcrest Ave
Olney, MD 20832-1422
Phone (301) 774-5400

Other identifiers 1

IdentifierTypeStateIssuer
058291300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081016000479 DC Part B Supplier - Clinic/Group Practice 5294893426 Receives reassigned benefits from 1 practitioner
Practice locations: Olney, MD

National Provider Directory

National Provider Directory

Locations

18213 Hillcrest Ave
Olney, MD 20832
Phone (301) 260-7600

18109 Prince Philip Dr
Ste 275
Olney, MD 20832
Phone (240) 342-2136

Practitioners & affiliated clinicians

Practitioners 1

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609967736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18213 HILLCREST AVE",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321422",
            "telephone_number": "301-774-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18109 PRINCE PHILIP DR STE 275",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321576",
            "telephone_number": "301-774-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLNEY MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-07-21",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "COLON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-774-5555"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058291300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.