Individual provider Active NPI

Gwendolyn Challenger, PA

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1780764092
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA030541 Issued in DC
Practice address
650 Pennsylvania Ave SE
Washington, DC 20003-4318
Phone
(202) 610-9570
NPI assigned
Oct 17, 2006
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA030541 DC Primary

Addresses

Primary practice location

650 Pennsylvania Ave SE
Washington, DC 20003-4318

Mailing address

650 Pennsylvania Ave SE
Washington, DC 20003-4318
Phone (202) 610-9570

Other practice location 1

1328 Southern Ave SE Ste 205
Washington, DC 20032
Phone (202) 610-9570

Other practice location 2

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440 ext. 4342

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017001231 DC Practitioner - Physician Assistant 1557613759 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA030541DCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Health Solutions, LLC CurrentSince Apr 28, 2025 Accepting new patients

Locations

650 Pennsylvania Ave SE
Ste 330
Washington, DC 20003
Phone (202) 610-9570

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1780764092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PENNSYLVANIA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034318",
            "telephone_number": "202-610-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 PENNSYLVANIA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034318",
            "telephone_number": "202-610-9570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1328 Southern Ave SE Ste 205",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20032",
            "country_code": "US",
            "telephone_number": "202-610-9570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1065 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104592417",
            "country_code": "US",
            "telephone_number": "718-589-2440 x4342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHALLENGER",
        "first_name": "GWENDOLYN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA030541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.