Individual provider Active NPI

Andrea Durbin

  • Speech-Language Pathologist
  • Rockville, MD
National Provider Identifier
1689341497
Registry record updated Aug 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
02328L Issued in MD
Practice address
6121 Montrose Rd
Rockville, MD 20852-4803
Phone
(301) 770-8366
NPI assigned
Aug 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 02328L MD Primary

Addresses

Primary practice location

6121 Montrose Rd
Rockville, MD 20852-4803

Mailing address

413 S Collington Ave
Baltimore, MD 21231-2735
Phone (917) 913-5817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230622001852 DC Practitioner - Qualified Speech Language Pathologist 1759749880 Reassigns benefits to 1 organization
I20240610000003 MD Practitioner - Qualified Speech Language Pathologist 1759749880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Phone (240) 632-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02328LMDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 13, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 13, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Single Specialty Current Accepting new patients

Locations

4000 Garden City Dr
Fl 4
Hyattsville, MD 20785
Phone (227) 229-8532

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Organizations & group practices 4

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": "1630108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630108800000",
    "number": "1689341497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 S COLLINGTON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212312735",
            "telephone_number": "917-913-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524803",
            "telephone_number": "301-770-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURBIN",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-28",
        "last_updated": "2021-08-28",
        "certification_date": "2021-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "02328L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.