Individual provider Active NPI

Eran Kessous, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Silver Spring, MD
National Provider Identifier
1821033358
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
D0066523 Issued in MD
Practice address
11120 New Hampshire Ave
Suite 411
Silver Spring, MD 20904-2633
Phone
(301) 754-0505
Fax
(301) 754-0509
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X D0066523 MD Primary

Addresses

Primary practice location

11120 New Hampshire Ave
Suite 411
Silver Spring, MD 20904-2633

Mailing address

11120 New Hampshire Ave
Suite 411
Silver Spring, MD 20904-2633
Phone (301) 754-0505

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
I20100715000264 DC Practitioner - Sports Medicine 3274556329 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eran Kessous MD PCGroup PAC ID 1658403316, 2 clinicians

Practice addresses (Care Compare)

11120 New Hampshire Ave
Suite 411
Silver Spring, MD 20904-2620
Phone (301) 754-0505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0066523MDMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Dec 1, 2013 Accepting new patients
Eran Kessous MD PC Sports Medicine CurrentSince Dec 1, 2008 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Dec 1, 2013 Accepting new patients
Cedar Health Ventures, LLC Past Accepting new patients
Boston University Family Medicine, Inc. Past Accepting new patients
Montgomery Sports Medicine Center Sports Medicine PastSince Apr 6, 2021 Accepting new patients
Eran Kessous MD PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Eran Kessous MD PC Past Accepting new patients
Eran Kessous MD PC Past Accepting new patients
Eran Kessous MD PC Past Accepting new patients

Locations

6931 Arlington Rd
Ste 550
Bethesda, MD 20814
Phone (301) 754-0505

800 S Frederick Ave
Ste 110
Gaithersburg, MD 20877
Phone (301) 208-2273

3414 Olandwood Ct
Olney, MD 20832
Phone (301) 774-0500

11120 New Hampshire Ave
Ste 411
Silver Spring, MD 20904
Phone (301) 754-0505

11120 New Hampshire Ave
Silver Spring, MD 20904
Phone (301) 593-9612

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15259/brand/7/csg/1/fhir/r4
  • Direct secure messaging: eran.kessous.1@15259.direct.athenahealth.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1821033358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 411",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042633",
            "telephone_number": "301-754-0505",
            "fax_number": "301-754-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 411",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042633",
            "telephone_number": "301-754-0505",
            "fax_number": "301-754-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSOUS",
        "first_name": "ERAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MD",
            "license": "D0066523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.