Individual provider Active NPI

Nadya Andrea Clarke

  • Plastic Surgery Physician
  • Rockville, MD
National Provider Identifier
1619101953
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
D0090057 Issued in MD
Practice address
9601 Blackwell Rd Ste 260
Rockville, MD 20850-6487
Phone
(301) 500-0215
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X D0090057 MD Primary

Addresses

Primary practice location

9601 Blackwell Rd Ste 260
Rockville, MD 20850-6487

Mailing address

8860 Columbia 100 Pkwy
Ste 314
Columbia, MD 21045-2298
Phone (410) 740-9330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220408001881 MD Practitioner - Plastic and Reconstructive Surgery 5597059550
I20230915001331 DC Practitioner - Plastic and Reconstructive Surgery 5597059550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Drexel University College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19801 Observation Dr
Germantown, MD 20876-4070
Phone (301) 500-0215

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0090057MDMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bespoke Aesthetic Plastic Surgery Plastic Surgery CurrentSince Apr 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

9601 Blackwell Rd
Ste 260
Rockville, MD 20850
Phone (301) 500-0215

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

Interoperability endpoints

  • Direct secure messaging: nadya.clarke@direct.einstein.edu
  • Direct secure messaging: nclarke2708638@direct.trinity-health.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1619101953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8860 COLUMBIA 100 PKWY",
            "address_2": "STE 314",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452298",
            "telephone_number": "410-740-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BLACKWELL RD STE 260",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506487",
            "telephone_number": "301-500-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "NADYA",
        "middle_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2023-09-11",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D0090057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.