Alfred Lorenzo Phelps, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA030795 Issued in DC

Practice address

2041 Georgia Avenue, NW
Siute a
Washington, DC 20060

Phone

(202) 865-1183

Fax

(202) 865-3039

NPI assigned

Aug 3, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • MC Lean, VA
  • NPI 1073678637

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Largo, MD
  • NPI 1366781700

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Gaithersburg, MD
  • NPI 1497023188

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Kensington, MD
  • NPI 1578638425

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Halethorpe, MD
  • NPI 1942546486
  Medicare reassignment NPD
• Howard University

  • Multi-Specialty Clinic/Center
  • Washington, DC
  • NPI 1033163597
  Medicare reassignment
• Dimensions Healthcare Associates, Inc.

  • Anesthesiology Physician
  • Largo, MD
  • NPI 1346354834

  DC

  Medicare reassignment
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment
• Dimensions Health Associates Dba University of Maryland Capital Region

  • Internal Medicine Physician
  • Oxon Hill, MD
  • NPI 1407486293
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD

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

{
    "created_epoch": "1375488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1710319553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVENUE, NW",
            "address_2": "3400",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20060",
            "telephone_number": "202-865-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVENUE, NW",
            "address_2": "SIUTE A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20060",
            "telephone_number": "202-865-1183",
            "fax_number": "202-865-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "ALFRED",
        "middle_name": "LORENZO",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-03",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0005138",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030795",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005138",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0005138",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 2nd Street NE",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "20002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pharmacare at DC, LLC
• Pharmacy4Humanity
• Phase LL Academy
• Phase LL Academy, LLC
• Meagan Phelan, RD
• Benjamin Ryan Phelps, MD, MPH, CTROPMED
• Carmen Elise Phelps, LCSW-C, LICSW
• Chearie Phelps
• Darice Phelps
• Mary Phelps, MS, CNS

• Physician Assistant in Washington, DC
• Providers in Washington, DC by specialty
• Physician Assistant in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.