Organization Active NPI

Pulmonary Critical Care Associates, PC

  • Pulmonary Disease Physician
  • Washington, DC
National Provider Identifier
1780695973
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY CRITICAL CARE ASSOCIATES, PC
Practice address
1160 Varnum St NE
Suite 214
Washington, DC 20017-2107
Phone
(202) 526-5491
Fax
(202) 526-5434
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Dr. Octavius Douglas Polk Jr., M.D.NPI 1144231374
Title
Treasurer
Phone
(202) 526-5491

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
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

1160 Varnum St NE
Suite 214
Washington, DC 20017-2107

Mailing address

1160 Varnum St NE
Suite 214
Washington, DC 20017-2107
Phone (202) 526-5491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100329000229 DC Part B Supplier - Clinic/Group Practice 9133255235 Receives reassigned benefits from 3 practitioners
Practice locations: Washington, DC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
09D0954086Pulmonary Critical Care Associates, PC1160 Varnum Street NE Suite 214, Washington, DC 20017Certificate of waiverNov 16, 2026

National Provider Directory

National Provider Directory

Locations

1160 Varnum St NE
Ste 214
Washington, DC 20017
Phone (202) 526-5491

Practitioners & affiliated clinicians

Practitioners 5

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1780695973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE",
            "address_2": "SUITE 214",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172107",
            "telephone_number": "202-526-5491",
            "fax_number": "202-526-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE",
            "address_2": "SUITE 214",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172107",
            "telephone_number": "202-526-5491",
            "fax_number": "202-526-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY CRITICAL CARE ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "OCTAVIUS",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "202-526-5491",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.