| Bluerock Primary Care | |
|
3429 11th Pl Se Washington DC 20032-5903 | |
| (202) 796-9775 | |
| Not Available |
| Full Name | Bluerock Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 3429 11th Pl Se, Washington, District Of Columbia |
| Authorized Official Name and Position | Marc Berg (ADMINISTRATOR) |
| Authorized Official Contact | 2403800402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluerock Primary Care 5305 Blackistone Rd Bethesda MD 20816-1822 Ph: (240) 380-0402 | Bluerock Primary Care 3429 11th Pl Se Washington DC 20032-5903 Ph: (202) 796-9775 |
| NPI Number | 1831719806 |
|---|---|
| Provider Enumeration Date | 04/20/2020 |
| Last Update Date | 04/20/2020 |
| Medicare PECOS PAC ID | 3072943323 |
|---|---|
| Medicare Enrollment ID | O20200429000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831719806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Lisa K Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588664056 PECOS PAC ID: 8921063439 Enrollment ID: I20081006000307 |
| Provider Name | Jessica Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225692973 PECOS PAC ID: 6901149657 Enrollment ID: I20190520002527 |
| Provider Name | Alka Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326363870 PECOS PAC ID: 0143463356 Enrollment ID: I20200929002553 |
| Provider Name | Sylvia Lysandra Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265667190 PECOS PAC ID: 9931378098 Enrollment ID: I20240106000432 |
| Provider Name | Brenda K Mills-layne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720810898 PECOS PAC ID: 2567903388 Enrollment ID: I20240920000492 |
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