Pediatric Care of Rockville PA

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

PEDIATRIC CARE OF ROCKVILLE PA

Practice address

1201 Seven Locks Rd Ste 201
Rockville, MD 20854-2963

Phone

(301) 881-7995

Fax

(301) 881-8451

NPI assigned

Feb 12, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Michael Jones

Title

Administrator

Phone

(301) 881-7995

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pediatric Care of Rockville Other name

Tax ID family

Pediatric Care of Rockville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Care of Rockville PA

  • Pediatrics Physician
  • Rockville, MD
  • NPI 1184730509
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mallory Lostumbo

  • Pediatrics Physician
  • Rockville, MD
  • NPI 1073923132
  NPD

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1811453020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SEVEN LOCKS RD STE 201",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208542963",
            "telephone_number": "301-881-7995",
            "fax_number": "301-881-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SEVEN LOCKS RD STE 201",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208542963",
            "telephone_number": "301-881-7995",
            "fax_number": "301-881-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE OF ROCKVILLE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-12",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-881-7995",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147151101",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147151100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Care of Rockville",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pediatric Care of Rockville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth Peck
• Michael J Peck, M.D.
• Pattijean Peck
• Axel Syrano Pedeme Kuenzob
• Pediatric Care of Rockville PA
• Pediatric Dentistry at North Bethesda
• Pediatric Gastroenterology of Greater Washington
• Pediatric Inpatient Associates, P.C.
• Pediatrix Medical Group of the Mid-Atlantic PC
• Pediatrix Medical Group of the Mid-Atlantic PC

• Adolescent and Children Mental Health Clinic/Center in Rockville, MD
• Providers in Rockville, MD by specialty
• Adolescent and Children Mental Health Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.