Individual provider Active NPI

Lauren Marie Vasta, M.D.

  • Pediatric Hematology & Oncology Physician
  • Bethesda, MD
National Provider Identifier
1790079804
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
0101252374 Issued in VA
Practice address
8901 Wisconsin Ave RM 4340
Bethesda, MD 20889-0004
Phone
(301) 400-1663
Fax
(301) 400-1662
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101252374 VA
Pediatric Hematology & Oncology Physician 2080P0207X 0101252374 VA Primary

Addresses

Primary practice location

8901 Wisconsin Ave RM 4340
Bethesda, MD 20889-0004

Mailing address

8901 Wisconsin Ave RM 4340
Bethesda, MD 20889-0004
Phone (301) 319-1663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20140610000569 AK Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2769606995

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101252374VAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1790079804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE RM 4340",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-319-1663",
            "fax_number": "301-319-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE RM 4340",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-400-1663",
            "fax_number": "301-400-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASTA",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101252374",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "VA",
            "license": "0101252374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.