Individual provider Active NPI

Colleen M Meaney, PA-C

  • Physician Assistant
  • Bethesda, MD
National Provider Identifier
1750726451
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0005009 Issued in MD
Practice address
Walter Reed Credentials Office
Bethesda, MD 20889-4604
Phone
(301) 295-4000
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0005009 MD Primary

Addresses

Primary practice location

Walter Reed Credentials Office
Bethesda, MD 20889-4604

Mailing address

Walter Reed National Military Medical Center
Bethesda, MD 20889-0001
Phone (301) 295-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240118002922 MD Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 4183076821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C0005009MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1750726451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WALTER REED NATIONAL MILITARY MEDICAL CENTER",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-295-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALTER REED CREDENTIALS OFFICE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208894604",
            "telephone_number": "301-295-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEANEY",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.