NPIMap

Organization Active NPI

Potomac Eldercare Physicians

  • Internal Medicine Physician
  • Potomac, MD
National Provider Identifier
1760028906
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
POTOMAC ELDERCARE PHYSICIANS
Practice address
11100 Powder Horn Dr
Potomac, MD 20854-2539
Phone
(202) 604-1405
NPI assigned
Nov 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Authorized official

Name
Matthew BruntelNPI 1114102134
Title
DO
Phone
(202) 604-1405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

11100 Powder Horn Dr
Potomac, MD 20854-2539

Mailing address

11100 Powder Horn Dr
Potomac, MD 20854-2539
Phone (202) 604-1405

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574380800000",
    "number": "1760028906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 POWDER HORN DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542539",
            "telephone_number": "202-604-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 POWDER HORN DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542539",
            "telephone_number": "202-604-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC ELDERCARE PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-22",
        "last_updated": "2019-11-22",
        "status": "A",
        "authorized_official_last_name": "BRUNTEL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "202-604-1405"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.