PBJ Healthcare Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PBJ HEALTHCARE SERVICES LLC

Practice address

2205 16TH St SE
Washington, DC 20020-4333

Phone

(240) 425-2245

NPI assigned

May 1, 2020

Organization subpart

No

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

Authorized official

Name

Petra Bih Jua, BSN RNNPI 1003451873

Title

Ceo

Phone

(301) 370-8049

Specialties & licenses 10

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Petra Jua

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Washington, DC
  • NPI 1003451873

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588291200000",
    "number": "1740801638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 16TH ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204333",
            "telephone_number": "240-425-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 16TH ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204333",
            "telephone_number": "240-425-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBJ HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A",
        "authorized_official_last_name": "JUA",
        "authorized_official_first_name": "PETRA",
        "authorized_official_middle_name": "BIH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-370-8049",
        "authorized_official_credential": "BSN RN"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "LAPTOP",
            "affiliation": "N",
            "address_1": "2205 16th St SE",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200204333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Regina Payton
• Rosa Jacqueline Paz Soldan
• Esperanza Paz-Varela
• Maya Paz, MSOT
• PBH Health LLC
• PC &CC
• PC Milestones
• PCRM Clinic (Barnard Medical Center)
• Pdi Health DC LLC
• Pdi Health DC LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Washington, DC
• Providers in Washington, DC by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.