Organization Active NPI

Sleep Disorders CTRS of the Mid Atlantic LLC

  • Specialist
  • Vienna, VA
National Provider Identifier
1689767683
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0810002163 Issued in VA
Legal business name
SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC
Practice address
2235 Cedar LN
Suite 202
Vienna, VA 22182-5247
Phone
(703) 752-7881
Fax
(703) 752-7880
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
James Perlstrom, PHD
Title
President
Phone
(703) 752-7881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 0810002163 VA Primary

Addresses

Primary practice location

2235 Cedar LN
Suite 202
Vienna, VA 22182-5247

Mailing address

2235 Cedar LN
Suite 202
Vienna, VA 22182-5202
Phone (703) 752-7881

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040526001149 DC Part B Supplier - Clinic/Group Practice 2264413137 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rockville, MD; Vienna, VA
O20090120000255 MD Part B Supplier - Clinic/Group Practice 2264413137 Receives reassigned benefits from 5 practitioners
Practice locations: Annapolis, MD; Glen Burnie, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1047427Sleep Disorders Center of the Mid - Atlantic2235 Cedar Lane - Suite 201, Vienna, VA 22182Certificate of waiverNov 3, 2027

National Provider Directory

National Provider Directory

Locations

2530 Riva Rd
Ste 1
Annapolis, MD 21401
Phone (410) 582-9300

2530 Riva Rd
Lowr
Annapolis, MD 21401

2310 Research Blvd
302
Rockville, MD 20850
Phone (443) 305-6877

10875 Main St
Ste 212
Fairfax, VA 22030
Phone (203) 494-6958

2235 Cedar Ln
Ste 202
Vienna, VA 22182
Phone (703) 752-7881

Practitioners & affiliated clinicians

Practitioners 5

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1689767683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 CEDAR LN",
            "address_2": "SUITE 202",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221825202",
            "telephone_number": "703-752-7881",
            "fax_number": "703-752-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 CEDAR LN",
            "address_2": "SUITE 202",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221825247",
            "telephone_number": "703-752-7881",
            "fax_number": "703-752-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "PERLSTROM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-752-7881",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0810002163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; 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.