JEFFREY PETER INDRISANO (NPI# 1477599843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477599843 |
| Entity Type | Individual |
| Full Name | JEFFREY PETER INDRISANO |
| Credential | M.D. |
| Practice Address |
6410 Rockledge Dr Suite 401 Bethesda MD 20817-1809 |
| Mailing Address |
9600 Pulaski Park Dr 103 Baltimore MD 21220-1400 |
| Practice Telephone | 3018905001 |
| Practice Fax Number | 3018905193 |
| Mailing Telephone | 4437258762 |
| Mailing Fax Number | 4107808790 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
D0037975 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | STATE LICENSE NUMBER | D0037975 | 01 |
| DEA | BI1394650 | 01 |
| Street Address |
6410 ROCKLEDGE DR SUITE 401 |
| City | BETHESDA |
| State | MD |
| Zip Code | 20817-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354748 | Suburban/nrh Medical Rehabilitation Inc | Clinic/Center | 6410 Rockledge Dr, Ste 600, Bethesda, MD 20817-1844 | 2005-05-31 |
| 1477165157 | Charlotte Eleanor Vogler | Student in an Organized Health Care Education/Training Program | 6410 Rockledge Dr, Bethesda, MD 20817-1809 | 2020-08-23 |
| 1699246090 | Cristina Garcia | Physical Therapist | 6410 Rockledge Dr, Bethesda, MD 20817-1809 | 2018-12-10 |
| 1003340092 | Metro Acupuncture Wellness Clinic Pllc | Acupuncturist | 6410 Rockledge Dr, Suite 310, Bethesda, MD 20817-1809 | 2017-04-17 |
| 1104378173 | Pavel Klein | Social Worker | 6410 Rockledge Dr, Suite 610, Bethesda, MD 20817-1809 | 2016-10-26 |
| 1700334026 | Kerry Callahan | Physical Therapist | 6410 Rockledge Dr, 600, Bethesda, MD 20817-1809 | 2016-09-15 |
| 1083161343 | Katherine Koenig | Physical Therapist | 6410 Rockledge Dr, Suite 600, Bethesda, MD 20817-1809 | 2016-09-04 |
| 1174077994 | Sarah Kuzmack | Physical Therapist | 6410 Rockledge Dr, Suite 600, Bethesda, MD 20817-1809 | 2016-08-10 |
| 1063890234 | Suburban/nrh Rehabilitation Hospital, Inc. | Physical Therapist | 6410 Rockledge Dr, Suite 600, Bethesda, MD 20817-1809 | 2015-05-08 |
| 1487069605 | Melanie Sara Niemeyer | Physician Assistant | 6410 Rockledge Dr, Suite 402, Bethesda, MD 20817-1809 | 2014-06-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972135291 | Super Smile Center of Bethesda | Dentist | 10320 Westlake Dr., Suite# 109, Bethesda, MD 20817 | 2020-02-05 |
| 1659918175 | Morgan Cheatham | Behavior Technician | Attn: Behavioral Health Works 6701 Democracy Blvd, Suite 300, Bethesda, MD 20817 | 2019-12-03 |
| 1780233601 | Natalie Milazzo | Behavior Technician | Attattn: Behavioral Health Works 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-09-04 |
| 1366090649 | Sarah Danko | Behavior Technician | Attn: Behavioral Health Works 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-08-29 |
| 1679120760 | Markita Mccurdy | Behavior Technician | 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-08-22 |
| 1548716277 | Roberta Glass | Psychiatry & Neurology | 9806 Marquette Dr., Bethesda, MD 20817 | 2016-09-01 |
| 1952725525 | Jenna Kuhn | Student in an Organized Health Care Education/Training Program | 6701 Democracy Blvd. Attn: Behavioral Health Works, Suite 300, Bethesda, MD 20817 | 2014-02-18 |
| 1912338088 | Nayereh Nina Ghamarian | Dentist | 6017 Bradley Blvd, Bethesda, MD 20817 | 2013-11-27 |
| 1386076495 | Hugo Galindo | Physical Therapist | 6410 Rockledge Drive, Suite 100, Nrh Rehabilitation Network Bethesda, Bethesda, MD 20817 | 2013-07-31 |
| 1538509260 | Anameti Usoro | Anesthesiology | 6430 Rockledge Dr Ste 160, Bethesda, MD 20817 | 2013-06-26 |
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| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
| 1134662877 | Chowdhury Medical Associates, LLC. | Internal Medicine | 5721 Grosvenor Ln, Bethesda, MD 20814-1833 | 2016-11-29 |
| 1710325717 | Scott Howard Snyder | Internal Medicine | 8901 Wisconsin Ave, Bldg 19, Floor 4, Division of Geriatric Medicine, Bethesda, MD 20889 | 2013-06-12 |
| 1194054171 | Fried and Wilks, LLC | Internal Medicine | 6430 Rockledge Dr, Suite 470, Bethesda, MD 20817-1805 | 2009-12-21 |
| 1164583043 | Kenneth Gregory Pugh | Internal Medicine | 8901 Wisconsin Ave, Department of Medicine, Bethesda, MD 20889-0001 | 2006-12-13 |
| 1093805301 | Susan J Miller | Internal Medicine | 8218 Wisconsin Ave, Suite Number 305, Bethesda, MD 20814-3107 | 2006-10-15 |
| 1881626059 | Roy Fried | Internal Medicine | 7758 Wisconsin Ave, # 211, Bethesda, MD 20814-3530 | 2006-07-07 |
| 1417983008 | Harjinder Kumar | Internal Medicine | Walter Reed National Military Ctr, 8901 Wisconsin Ave, Bethesda, MD 20889-5600 | 2006-06-24 |
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| 1598252371 | Wayne Medical Associate, Inc. | Internal Medicine | 7207 Hanover Pkwy Ste A, Greenbelt, MD 20770-2089 | 2018-04-17 |
| 1649775933 | Old Fashion Medicine, Inc | Internal Medicine | 95 Gatepost Lane, Apartment 1b, Frederick, MD 21701 | 2018-03-28 |
| 1982102943 | 3s Health LLC | Internal Medicine | 10400 Connecticut Ave Ste 206, Kensington, MD 20895-3941 | 2018-01-24 |
| 1225572233 | Pamela Denise Ponder | Internal Medicine | 2603 Portola Court, Odenton, MD 21113 | 2016-12-09 |
| 1912371832 | Phillip W. Stone, Md, LLC | Internal Medicine | 16013 Fields End Ct, Woodbine, MD 21797-7542 | 2015-11-16 |
| 1598023194 | Health First Medical Care LLC | Internal Medicine | 9650 Santiago Rd Ste 6, Columbia, MD 21045-3960 | 2012-05-02 |
| 1609141795 | Mattan Schuchman | Internal Medicine | 5210 Eastern Ave, Alpha Center #127, Baltimore, MD 21224 | 2012-03-21 |
| 1013204171 | Chantal Youssef | Internal Medicine | 13105 Bucks Ridge Ct, Ellicott City, MD 21042 | 2011-07-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.