Individual provider Active NPI

Rose Wilson, A.A.-C.

  • Anesthesiologist Assistant
  • Washington, DC
National Provider Identifier
1942648183
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA000036 Issued in DC
Practice address
110 Irving St NW
G2-67
Washington, DC 20010-3017
Phone
(202) 877-7500
NPI assigned
Jun 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA000036 DC Primary

Addresses

Primary practice location

110 Irving St NW
G2-67
Washington, DC 20010-3017

Mailing address

20944 Glenburn Ter
Ashburn, VA 20147-6491
Phone (703) 507-8193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130730000416 DC Practitioner - Anesthesiology Assistant 3870734197 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (703) 558-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA000036DCMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Hospital Center Corp CurrentSince May 1, 2013 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Jun 1, 2018 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Jun 1, 2018 Accepting new patients
Washington Hospital Center Corp CurrentSince May 1, 2013 Accepting new patients
Providence Health Services, Inc Anesthesiologist Assistant Past Accepting new patients
Washington Hospital Center Corp Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

2021 K St NW
Ste 408
Washington, DC 20006
Phone (202) 223-1024

110 Irving St NW
#G267
Washington, DC 20010
Phone (202) 425-6624

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1942648183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20944 GLENBURN TER",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476491",
            "telephone_number": "703-507-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "address_2": "G2-67",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103017",
            "telephone_number": "202-877-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROSE",
        "credential": "A.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "DC",
            "license": "AA000036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.