Individual provider Active NPI

Roberta F Palestine, MD

  • Dermatology Physician
  • Bethesda, MD
National Provider Identifier
1841285582
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D0027831 Issued in MD
Practice address
6410 Rockledge Dr
Ste 201
Bethesda, MD 20817-1809
Phone
(301) 530-8300
Fax
(301) 530-4638
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X D0027831 MD Primary
Procedural Dermatology Physician 207NS0135X D0027831 MD

Addresses

Primary practice location

6410 Rockledge Dr
Ste 201
Bethesda, MD 20817-1809

Mailing address

6410 Rockledge Dr
Ste 201
Bethesda, MD 20817-1809
Phone (301) 530-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0027831MDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1841285582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR",
            "address_2": "STE 201",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171809",
            "telephone_number": "301-530-8300",
            "fax_number": "301-530-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR",
            "address_2": "STE 201",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171809",
            "telephone_number": "301-530-8300",
            "fax_number": "301-530-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALESTINE",
        "first_name": "ROBERTA",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0027831",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MD",
            "license": "D0027831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.