NPIMap

Organization Active NPI

Chesapeake&Washington Heart Care, PC

  • Cardiovascular Disease Physician
  • Waldorf, MD
National Provider Identifier
1669585113
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CHESAPEAKE&WASHINGTON HEART CARE, PC
Practice address
12070 Old Line Ctr
Suite 303
Waldorf, MD 20602-2513
Phone
(301) 645-5100
Fax
(301) 645-3695
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
Stuart Jay J Carson
Title
Chief Operation Officer
Phone
(240) 994-5949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

12070 Old Line Ctr
Suite 303
Waldorf, MD 20602-2513

Mailing address

12070 Old Line Ctr
Ste 303
Waldorf, MD 20602-2513
Phone (301) 645-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040629000804 MD Part B Supplier - Clinic/Group Practice 5496731440 Receives reassigned benefits from 17 practitioners
Practice locations: Waldorf, MD; Prince Frederick, MD; Leonardtown, MD; La Plata, MD; Clinton, MD
O20130605000017 DC Part B Supplier - Clinic/Group Practice 5496731440 Receives reassigned benefits from 4 practitioners
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations

41680 Miss Bessie Dr
Ste 202
Leonardtown, MD 20650
Phone (301) 475-3240

41680 Miss Bessie Dr
Ste 2020
Leonardtown, MD 20650

12070 Old Line Ctr
Ste 303
Waldorf, MD 20602
Phone (301) 645-5100

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1669585113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "STE 303",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513",
            "telephone_number": "301-645-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "SUITE 303",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513",
            "telephone_number": "301-645-5100",
            "fax_number": "301-645-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE&WASHINGTON HEART CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "STUART JAY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF OPERATION OFFICER",
        "authorized_official_telephone_number": "240-994-5949"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.