Kristina E Andersson, D.O.
Individual provider Active NPI Pediatrics Physician · Riverdale, MD
NPI 1881865590 · NPPES record last updated Mar 20, 2008
Key facts
- NPI
- 1881865590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- H0067114 (MD)
- Practice address
- 6103 Baltimore Ave
Suite T1
Riverdale, MD 20737-1966 - Phone
- (301) 277-2779
- Fax
- (301) 277-6947
- NPI assigned
- Mar 20, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170111001315 | DC | Practitioner - Pediatric Medicine | 9931480654 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H0067114 | MD | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marys Center for Maternal and Child Care Inc | Current |
Accepting new patients | |
| Mary'S Center for Maternal and Child Care, Inc | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
100 Gallatin St NE
Washington, DC 20011
Phone (202) 545-0515
2333 Ontario Rd NW
Washington, DC 20009
Phone (202) 420-7175
6315 5th St NW
Washington, DC 20011
Phone (202) 671-6080
3912 Georgia Ave NW
Washington, DC 20011
Phone (844) 796-2797
8908 Riggs Rd
Hyattsville, MD 20783
Phone (301) 422-5900
344 University Blvd W
Silver Spring, MD 20901
Phone (301) 439-0300
Interoperability endpoints
- kristina.andersson@maryscenter.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | H0067114 | MD | Yes |
Addresses
Primary practice location
6103 Baltimore Ave
Suite T1
Riverdale, MD 20737-1966
Mailing address
6103 Baltimore Ave
Suite T1
Riverdale, MD 20737-1966
Phone (301) 277-2779
Other providers in Riverdale, MD
- Charles Amakor
- America Medical Equipment Supply, Inc.
- American Royal Homecare
- Olubukola Amusu
- Lorian Anderson
- Michaelle Andre
- Lynette Jabachi Anele
- Chinyereugo Anene
- Ndingsa Anevindzah Eli
- Anitha Menon, M.D.
All providers in Riverdale, MD · Pediatrics Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.