Individual provider Active NPI

Lawrence W Widerlite, M.D.

  • Gastroenterology Physician
  • Chevy Chase, MD
National Provider Identifier
1750350294
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
D0006493 Issued in MD
Practice address
5550 Friendship Blvd
Suite T-90
Chevy Chase, MD 20815-7256
Phone
(240) 737-0085
Fax
(301) 654-2986
NPI assigned
Mar 16, 2006
Last updated
Jul 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D0006493 MD Primary

Addresses

Primary practice location

5550 Friendship Blvd
Suite T-90
Chevy Chase, MD 20815-7256

Mailing address

12510 Prosperity Dr
Suite 200
Silver Spring, MD 20904-1663
Phone (240) 485-5200

Other identifiers 1

IdentifierTypeStateIssuer
D0006493OtherMDSTATE LICENSE

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
I20081219000018 DC Practitioner - Gastroenterology 5799851143 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0006493MDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endoscopy Center of Washington DC LP Current Accepting new patients
Capital Digestive Care LLC Gastroenterology CurrentSince Sep 1, 2008 Accepting new patients
Capital Digestive Care, LLC Gastroenterology CurrentSince Sep 1, 2008 Accepting new patients
First Class Anesthesia, LLC Past Accepting new patients
David a. Morowitz Gastroenterology Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5550 Friendship Blvd
Ste T90
Chevy Chase, MD 20815
Phone (301) 654-2521

12510 Prosperity Dr
Ste 200
Silver Spring, MD 20904
Phone (240) 485-5200

Interoperability endpoints

  • Direct secure messaging: lawrence.widerlite.capitaldigestivecare@directaddress.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1750350294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12510 PROSPERITY DR",
            "address_2": "SUITE 200",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041663",
            "telephone_number": "240-485-5200",
            "fax_number": "301-625-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 FRIENDSHIP BLVD",
            "address_2": "SUITE T-90",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208157256",
            "telephone_number": "240-737-0085",
            "fax_number": "301-654-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDERLITE",
        "first_name": "LAWRENCE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0006493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "D0006493",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.