Individual provider Active NPI

Kandie S. Tate, M.D.

  • Family Medicine Physician
  • Washington, DC
National Provider Identifier
1730340100
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
000 Issued in DC
Practice address
2139 Georgia Ave NW
Faculty Prac Plan
Washington, DC 20001
Phone
(202) 865-7499
Fax
(202) 865-3875
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 000 DC Primary

Addresses

Primary practice location

2139 Georgia Ave NW
Faculty Prac Plan
Washington, DC 20001

Mailing address

2024 Georgia NW Ave 2ND
Washington, DC 20001-3027
Phone (202) 865-6679

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
I20111012000361 DC Practitioner - Family Practice 9032381215 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000DCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Care, Inc. CurrentSince Aug 22, 2011 Accepting new patients
Howard University Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Unity Health Care Inc. CurrentSince Aug 22, 2011 Accepting new patients
Medical Faculty Associates, Inc Past Accepting new patients

Locations

2139 Georgia Ave NW
Washington, DC 20001
Phone (202) 865-1121

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

2101 Medical Park Dr
Ste 305
Silver Spring, MD 20902
Phone (301) 754-0833

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1730340100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 GEORGIA NW AVE 2ND",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200013027",
            "telephone_number": "202-865-6679",
            "fax_number": "202-865-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 GEORGIA AVE NW",
            "address_2": "FACULTY PRAC PLAN",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20001",
            "telephone_number": "202-865-7499",
            "fax_number": "202-865-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "KANDIE",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.