NPIMap

Organization Active NPI

Wisconsin Ave Psychiatric Center Inc

Doing business as Psychiatric Institute of Washington

  • Psychiatric Hospital
  • Washington, DC
National Provider Identifier
1871549949
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
HFD01-0011 Issued in DC
Legal business name
WISCONSIN AVE PSYCHIATRIC CENTER INC
Doing business as
Psychiatric Institute of Washington
Practice address
4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone
(202) 885-5600
NPI assigned
May 26, 2006
Last updated
Jun 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Authorized official

Name
Steve Filton
Title
Vice President
Phone
(610) 768-3482

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Psychiatric Hospital 283Q00000X HFD01-0011 DC Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

4228 Wisconsin Ave NW
Washington, DC 20016-2138

Mailing address

4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone (202) 885-5600

Other identifiers 4

IdentifierTypeStateIssuer
208290000MedicaidMD
026402100MedicaidDC
026392500MedicaidDC
074500600MedicaidMD

Other names 1

  • Psychiatric Institute of Washington Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040422001139 DC Part B Supplier - Clinic/Group Practice 5991791162 Receives reassigned benefits from 57 practitioners
Practice locations: Washington, DC
O20100326000431 DC Part A Provider - Hospital 5991791162 Practice locations: Washington, DC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871549949. Details of each certification follow.

Hospital certification: CCN 094004

Legal name
WISCONSIN AVE PSYCHIATRIC CENTER INC
Doing business as
PSYCHIATRIC INSTITUTE OF WASHINGTON
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Oct 1, 1971
Last certification
Mar 21, 2008
Beds
104
Ownership / control type
Private (not for profit)
Organization structure
CorporationProprietary
Incorporated
Jun 8, 1994 in DE
Enrollment address
4228 Wisconsin Ave. N.W.
Washington, DC 20016-2138
Other Hospital Practice Location
Hospital subgroups
Psychiatric unit

Care Compare: Hospital

Medicare Care Compare
Listed as
Psychiatric Institute of WashingtonCCN 094004 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Wisconsin Ave Psych Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
George H Brunner Individual Corporate OfficerAsst Secretary Apr 24, 2014 100%
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary Apr 24, 2014 100%
Matthew J Peterson Individual Corporate OfficerPresident Sep 19, 2019 100%
Corporate DirectorPresident Sep 19, 2019 33.3%
Operational/Managerial ControlPresident Sep 19, 2019 100%
Thomas M Day Individual Corporate OfficerVice President Jul 20, 2021 100%
Corporate DirectorVice President Jul 20, 2021 33.3%
Steve Filton Individual Corporate OfficerVP, Board Member Apr 24, 2014 100%
Corporate DirectorVP, Board Member Apr 24, 2014 33.3%
Operational/Managerial ControlVP, Board Member Apr 24, 2014 100%
Gokhan Tari Individual Contracted Managing EmployeeCfo Jun 5, 2024
Corporate OfficerCfo Jun 5, 2024
Cheryl K Ramagano Individual Corporate OfficerTreasurer Apr 24, 2014 100%
Operational/Managerial ControlTreasurer Apr 24, 2014 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation 5% Or Greater Indirect Ownership Interest Apr 24, 2014 100%
James M Coleman Individual Contracted Managing EmployeeSr Reimbursement MNGR Apr 24, 2014 50%
Eric Amoh Individual Contracted Managing EmployeeCeo Jun 16, 2023
Corporate OfficerCeo Jun 16, 2023
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation, Management services company, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 24, 2014 100%
Operational/Managerial Control Apr 24, 2014 100%
Alan B Miller Individual 5% Or Greater Indirect Ownership InterestChairman Mar 18, 2024 87.4%

Facilities with the same owner 172

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 172

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1871549949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "202-885-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "202-885-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN AVE PSYCHIATRIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "610-768-3482"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "DC",
            "license": "HFD01-0011",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208290000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026402100",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026392500",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074500600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Institute of Washington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Psychiatric Institute of Washington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.