Individual provider Active NPI

Thomas Shaver

  • Psychiatry Physician
  • Washington, DC
National Provider Identifier
1790120137
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD042977 Issued in DC
Practice address
1310 Southern Ave SE
Washington, DC 20032-4623
Phone
(202) 360-4787
NPI assigned
Apr 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD042977 DC Primary

Addresses

Primary practice location

1310 Southern Ave SE
Washington, DC 20032-4623

Mailing address

10400 Connecticut Ave Ste 500
Kensington, MD 20895-3944
Phone (202) 360-4787

Other practice location 1

2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone (202) 741-3000

Other practice location 2

2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone (202) 741-3000

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
I20180627002585 DC Practitioner - Psychiatry 5890041214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
George Washington University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mbi Health Services LLCGroup PAC ID 5294990453, 20 clinicians

Practice addresses (Care Compare)

4130 Hunt PL NE
Washington, DC 20019-3565
Phone (202) 388-4300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD042977DCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mbi Health Services LLC CurrentSince Aug 14, 2018 Accepting new patients

Locations

4017 Minnesota Ave NE
Washington, DC 20019
Phone (202) 388-9202

4130 Hunt Pl NE
Washington, DC 20019
Phone (202) 388-4320

7200 Wisconsin Ave
Ste 702
Bethesda, MD 20814
Phone (202) 215-5348

Organizations & group practices 1

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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1790120137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 CONNECTICUT AVE STE 500",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208953944",
            "telephone_number": "202-360-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324623",
            "telephone_number": "202-360-4787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Pennsylvania Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200373201",
            "country_code": "US",
            "telephone_number": "202-741-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 Pennsylvania Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200373201",
            "country_code": "US",
            "telephone_number": "202-741-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAVER",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD042977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.