Individual provider Active NPI

Christopher P Michetti, MD

  • Trauma Surgery Physician
  • Upper Marlboro, MD
National Provider Identifier
1700807179
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
D96725 Issued in MD
Practice address
901 Harry S Truman Dr N
Upper Marlboro, MD 20774-5477
Phone
(240) 677-3000
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 0101231420 VA
Trauma Surgery Physician 2086S0127X D96725 MD Primary

Addresses

Primary practice location

901 Harry S Truman Dr N
Upper Marlboro, MD 20774-5477

Mailing address

3300 Gallows Rd
Physician Billing
Falls Church, VA 22042-3307
Phone (703) 776-1110

Other practice location 1

3300 Gallows Rd
Physician Billing
Falls Church, VA 22042-3307
Phone (703) 776-1110

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmichetti28283@soc.inova.org Health Information Exchange (HIE) Inova Health Care Services

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20120726000262 DC Practitioner - General Surgery 0840456448 Reassigns benefits to 2 organizations
I20231115001143 MD Practitioner - Critical Care (Intensivists) 0840456448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

901 Harry S Truman Dr N
Upper Marlboro, MD 20774-5477
Phone (240) 677-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D96725MDMDTrauma Surgery Physician
0101231420VAMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Oct 10, 2023 Accepting new patients
Inova Health Care Services Trauma Surgery CurrentSince Aug 1, 2001 Accepting new patients
Dimensions Healthcare Associates, Inc. Current Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Sep 25, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Dimensions Health Corporation Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

3299 Woodburn Rd
Ste 220
Annandale, VA 22003
Phone (220) 270-3747

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

8503 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 208-1741

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • Direct secure messaging: cmichetti1030309@direct.umm.edu
  • Direct secure messaging: cmichetti28283@soc.inova.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1700807179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "address_2": "PHYSICIAN BILLING",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-1110",
            "fax_number": "703-776-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HARRY S TRUMAN DR N",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745477",
            "telephone_number": "240-677-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_2": "Physician Billing",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-1110",
            "fax_number": "703-776-2917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHETTI",
        "first_name": "CHRISTOPHER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "VA",
            "license": "0101231420",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MD",
            "license": "D96725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmichetti28283@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8503 Arlington Blvd Ste 200",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.