Individual provider Active NPI

Maria Victoria Laserna, PA-C

  • Medical Physician Assistant
  • Chevy Chase, MD
National Provider Identifier
1649412420
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C07530 Issued in MD
Practice address
5530 Wisconsin Ave Ste 1418
Chevy Chase, MD 20815-4302
Phone
(301) 986-1880
NPI assigned
Mar 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9104794 FL
Medical Physician Assistant 363AM0700X C07530 MD Primary

Addresses

Primary practice location

5530 Wisconsin Ave Ste 1418
Chevy Chase, MD 20815-4302

Mailing address

5530 Wisconsin Ave Ste 1418
Chevy Chase, MD 20815-4302
Phone (301) 986-1880

Other practice location 1

7700 SW 104th St
Miami, FL 33156
Phone (305) 279-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090710000326 FL Practitioner - Physician Assistant 7315099066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group of Florida, P.a.Group PAC ID 1153367107, 54 clinicians

Practice addresses (Care Compare)

1001 NW 13TH St
Suite 100
Boca Raton, FL 33486-2269
Phone (561) 750-0544

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C07530MDMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mlaserna@dcm.emadirect.md

Organizations & group practices 1

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": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1649412420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE STE 1418",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154302",
            "telephone_number": "301-986-1880",
            "fax_number": "954-780-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE STE 1418",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154302",
            "telephone_number": "301-986-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7700 SW 104th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "33156",
            "country_code": "US",
            "telephone_number": "305-279-7546",
            "fax_number": "954-780-8980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASERNA",
        "first_name": "MARIA",
        "middle_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104794",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C07530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.