Individual provider Active NPI

Lorraine Beraho, M.D., M.P.H.

  • Pediatrics Physician
  • Rockville, MD
National Provider Identifier
1710242789
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
156809 Issued in CA
Practice address
9740 Traville Gateway Dr
Rockville, MD 20850-7409
Phone
(301) 605-0692
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0116024926 VA
Pediatrics Physician 208000000X 156809 CA Primary

Addresses

Primary practice location

9740 Traville Gateway Dr
Rockville, MD 20850-7409

Mailing address

9740 Traville Gateway Dr
Rockville, MD 20850-7409
Phone (301) 605-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150918000879 DC Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 9537476809 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156809CAMDPediatrics Physician
0116024926VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pediatrics CurrentSince Nov 15, 2021 Accepting new patients
Kiira Health Practice Ca PC Current Accepting new patients
Children'S Hospital Current Accepting new patients
Children'S Hospital CurrentSince Nov 15, 2021 Accepting new patients
Positive Development of California PC Past Accepting new patients
Total Access Medical Services LLC Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

Interoperability endpoints

  • Direct secure messaging: lberaho1325304@direct.hopkinsmedicine.org
  • FHIR API: https://api.platform.athenahealth.com/16248/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1710242789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9740 TRAVILLE GATEWAY DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507409",
            "telephone_number": "301-605-0692",
            "fax_number": "202-548-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9740 TRAVILLE GATEWAY DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507409",
            "telephone_number": "301-605-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERAHO",
        "first_name": "LORRAINE",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0116024926",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "156809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.