Individual provider Active NPI

Vimla Bhooshan, M.D.

  • Diagnostic Radiology Physician
  • Fort Washington, MD
National Provider Identifier
1770620874
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0025261 Issued in MD
Practice address
11711 Livingston Rd
Fort Washington, MD 20744-5151
Phone
(301) 203-2247
Fax
(301) 292-1172
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0025261 MD Primary

Addresses

Primary practice location

11711 Livingston Rd
Fort Washington, MD 20744-5151

Mailing address

9739 Avenel Farm Dr
Potomac, MD 20854-5413
Phone (301) 203-2247

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
I20050301000991 DC Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 6002869021 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14808MDMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Faculty Associates, Inc CurrentSince Jun 8, 2020 Accepting new patients
Blackwell Physicians, LLC Diagnostic Radiology CurrentSince Nov 1, 2021 Accepting new patients
Community Radiology Associates Inc Diagnostic Radiology Past Accepting new patients
Adventist Hospital-Based Providers, LLC Diagnostic Radiology Past Accepting new patients
Ft Washington Radiology Past Accepting new patients

Locations

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

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

11711 Livingston Rd
Ft Washington, MD 20744
Phone (301) 203-2250

9601 Blackwell Rd
Ste 150
Rockville, MD 20850
Phone (240) 864-1100

Organizations & group practices 5

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770620874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9739 AVENEL FARM DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208545413",
            "telephone_number": "301-203-2247",
            "fax_number": "301-292-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 LIVINGSTON RD",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445151",
            "telephone_number": "301-203-2247",
            "fax_number": "301-292-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHOOSHAN",
        "first_name": "VIMLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0025261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, MD

Sources for this page

Verify at the official NPI Registry.