DR. JUSTIN MYGATT (NPI# 1770908717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770908717 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN MYGATT |
| Credential | MD, PHD |
| Practice Address |
8901 Wisconsin Ave Bethesda MD 20889-0004 |
| Mailing Address |
8164 Amethyst Dr Mc Lean VA 22102-3926 |
| Practice Telephone | 3012954000 |
| Mailing Telephone | 4044273158 |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2020-07-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 0101259456 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
8901 WISCONSIN AVE |
| City | BETHESDA |
| State | MD |
| Zip Code | 20889-0004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093710246 | Rosemary Grace Carr-malone | Psychiatry & Neurology | 8901 Wisconsin Ave, Bethesda, MD 20889-5600 | 2005-06-15 |
| 1861017212 | Luke White | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-06-11 |
| 1538782545 | Alexander Pastino | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-26 |
| 1104449362 | Justin James De Vera | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-22 |
| 1881217180 | Reece Mckenzie | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-20 |
| 1073135695 | Alex Kim | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-18 |
| 1619599354 | Jacob Mickey Wyse | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-16 |
| 1770105413 | Anna M Russell | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-16 |
| 1699397364 | Jessica Nicole Clark | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-15 |
| 1558983296 | Mason Cleary Ditthardt Fortuno | Military Health Care Provider | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457987034 | Michael Franco | Student in an Organized Health Care Education/Training Program | Internal Medicine - Walter Reed Nmmc, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2020-03-16 |
| 1245862135 | Kay Tomashek | Pediatrics | National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889 | 2020-02-07 |
| 1104470657 | Adam Pink | Dentist | 8901 Wisconsin Ave Building 9 Floor 2, Bethesda, MD 20889 | 2019-08-01 |
| 1659939155 | Matthew Heller | Student in an Organized Health Care Education/Training Program | Psychiatry Walter Reed National Military Medica, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2019-05-30 |
| 1891258034 | Jane Ann Crotteau | Student in an Organized Health Care Education/Training Program | Pediatrics Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2019-04-12 |
| 1417434341 | Andrea Baeder | Dentist | 8901 Wisconsin Ave Bldg 9, Floor 2, Bethesda, AA 20889 | 2018-07-24 |
| 1942741723 | John Vance | Orthotist | Wrnmmc Orthotics, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2017-03-14 |
| 1790225704 | Sylvia Best | Pharmacist | 8901 Wisconsin Avenue Wrnmmc-, Americas Building 19- Internal Medicine Suite 2820, Bethesda, MD 20889 | 2017-02-24 |
| 1255783767 | Ryan Kaye | Student in an Organized Health Care Education/Training Program | Nsa Bethesda, 8901 Wisconsin Ave, Bethesda, Md 20889, Fpo, AA 20889 | 2016-07-08 |
| 1366861221 | Tara Elizabeth Brown | Internal Medicine | 8901 Wisconsin Avenue Walter Reed Nmmc, Bethesda, MD 20889 | 2014-04-08 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063904282 | Siobhan Ivy Telfer | Urology | Uob/nci, National Institutes of Health, Building 10, Room 1-5940w, Bethesda, MD 20892 | 2018-06-04 |
| 1205270667 | Sandeep Gurram | Urology | 10 Center Drive Building 10 Room 1-5940w, Bethesda, MD 20892-8424 | 2013-04-28 |
| 1275783375 | Mark Wayne Ball | Urology | 10 Center Drive Rm 2-5942, Bethesda, MD 20892-0005 | 2008-09-25 |
| 1841413275 | David James Osborn | Urology | 8930 Brown Dr, Bethesda, MD 20889-5629 | 2007-04-11 |
| 1588725071 | Peter Anthony Pinto | Urology | 10 Center Dr Msc 1210, Building 10, Crc, Room 1w-5940, Uob,nci, Nih, Bethesda, MD 20892-0001 | 2006-12-12 |
| 1003809310 | Mark Rosenblum | Urology | 6410 Rockledge Dr Ste 503, Bethesda, MD 20817-7822 | 2005-08-23 |
| 1700310273 | Zhao Li | Urology | Walter Reed National Military Ctr, 8901 Wisconsin Avenue, Bethesda, MD 20889-0001 | 2017-04-12 |
| 1194103861 | Michael Daneshvar | Urology | Nih Clinical Center, 10 Center Dr., Bethesda, MD 20814 | 2015-05-13 |
| 1386031425 | Bradley Roy Webster | Urology | 8600 Old Georgetown Rd, Bethesda, MD 20814-1422 | 2015-04-15 |
| 1114346004 | Devang Sharma | Urology | 6410 Rockledge Dr Ste 503, Bethesda, MD 20817-7822 | 2014-04-08 |
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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.