NPIMap

Individual provider Active NPI

Eric S Tannenbaum, M.D.

  • Cardiovascular Disease Physician
  • Rockville, MD
National Provider Identifier
1982649315
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
D0027886 Issued in MD
Practice address
15225 Shady Grove Rd
Suite 201
Rockville, MD 20850-3254
Phone
(301) 670-3000
Fax
(301) 924-0186
NPI assigned
Jun 19, 2006
Last updated
Apr 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X D0027886 MD Primary

Addresses

Primary practice location

15225 Shady Grove Rd
Suite 201
Rockville, MD 20850-3254

Mailing address

15225 Shady Grove Rd
Suite 201
Rockville, MD 20850-3254
Phone (301) 670-3000

Other identifiers 2

IdentifierTypeStateIssuer
383001200MedicaidMD
016713C83OtherMDMEDICARE PTAN

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0027886MDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Healthcare, Inc. Cardiovascular Disease Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Cardiac Associates, P.C. Cardiovascular Disease Past Accepting new patients
Suburban Ekg Interpreters Cardiovascular Disease Past Accepting new patients

Organizations & group practices 4

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1982649315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD",
            "address_2": "SUITE 201",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503254",
            "telephone_number": "301-670-3000",
            "fax_number": "301-924-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD",
            "address_2": "SUITE 201",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503254",
            "telephone_number": "301-670-3000",
            "fax_number": "301-924-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "ERIC",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D0027886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383001200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "016713C83",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.