Individual provider Active NPI

Monique Cherae Gourdine, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bethesda, MD
National Provider Identifier
1780660001
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00261500 Issued in NJ
Practice address
8901 Wisconsin Ave Dept of Podiatry BLD 19 2ND Floor
Bethesda, MD 20889-0001
Phone
(240) 274-6589
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 25MD00261500 NJ Primary

Addresses

Primary practice location

8901 Wisconsin Ave Dept of Podiatry BLD 19 2ND Floor
Bethesda, MD 20889-0001

Mailing address

4853 Cordell Ave Apt 1016
Bethesda, MD 20814-3024
Phone (240) 274-6589

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150806010073 MD Order and Referring Only - PodiatryPractitioner - Podiatry 9931413846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00261500NJMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1780660001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4853 CORDELL AVE APT 1016",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143024",
            "telephone_number": "240-274-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE DEPT OF PODIATRY BLD 19 2ND FLOOR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "240-274-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURDINE",
        "first_name": "MONIQUE",
        "middle_name": "CHERAE",
        "name_prefix": "Mrs.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00261500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.