Individual provider Active NPI

Anitha Subbanna

  • Pediatrics Physician
  • Prince Frederick, MD
National Provider Identifier
1851550453
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D84336 Issued in MD
Practice address
100 Hospital Rd
Prince Frederick, MD 20678-4017
Phone
(410) 535-4000
NPI assigned
Jun 9, 2008
Last updated
Jan 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101244415 VA
Pediatrics Physician 208000000X D84336 MD Primary
Hospitalist Physician 208M00000X D84336 MD

Addresses

Primary practice location

100 Hospital Rd
Prince Frederick, MD 20678-4017

Mailing address

5161 Sapphire Sky LN
Centreville, VA 20120-3012

Other practice location 1

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20081112000061 DC Practitioner - Pediatric Medicine 9234298829 Reassigns benefits to 1 organization
I20081125000699 VA Practitioner - HospitalistPractitioner - Pediatric Medicine 9234298829 Reassigns benefits to 3 organizations
I20211020003047 MD Practitioner - HospitalistPractitioner - Pediatric Medicine 9234298829 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D84336MDMDPediatrics Physician
0101244415VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mdics at Calvert LLC Hospitalist CurrentSince Sep 15, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 20, 2016 Accepting new patients
Adfinitas Health at Fauquier, LLC Hospitalist CurrentSince May 15, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Oct 4, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Southeastern Intensivist Services PC Hospitalist CurrentSince Jan 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 20, 2016 Accepting new patients

Locations

7250 Parkway Dr
Ste 500
Hanover, MD 21076
Phone (410) 999-1130

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 6
Rockville, MD 20852

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

10701 Rosemary Dr
Manassas, VA 20109
Phone (703) 257-3000

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

1890 Metro Center Dr
Reston, VA 20190
Phone (703) 709-1500

500 Hospital Dr
Warrenton, VA 20186
Phone (540) 316-5000

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1851550453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5161 SAPPHIRE SKY LN",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201203012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784017",
            "telephone_number": "410-535-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Joseph Siewick Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331709",
            "country_code": "US",
            "telephone_number": "703-391-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBBANNA",
        "first_name": "ANITHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101244415",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D84336",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MD",
            "license": "D84336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.