Individual provider Active NPI

Peter Zachary Konigsberg, M.D.

  • Pediatrics Physician
  • Potomac, MD
National Provider Identifier
1861765968
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0013447 Issued in MD
Practice address
10512 Willowbrook Dr
Potomac, MD 20854-4458
Phone
(301) 299-3217
Fax
(301) 983-9764
NPI assigned
Feb 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0013447 MD Primary

Addresses

Primary practice location

10512 Willowbrook Dr
Potomac, MD 20854-4458

Mailing address

10512 Willowbrook Dr
Potomac, MD 20854-4458
Phone (301) 299-3217

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0013447MDMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1861765968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10512 WILLOWBROOK DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208544458",
            "telephone_number": "301-299-3217",
            "fax_number": "301-983-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 WILLOWBROOK DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208544458",
            "telephone_number": "301-299-3217",
            "fax_number": "301-983-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIGSBERG",
        "first_name": "PETER",
        "middle_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-20",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0013447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.