| Foggy Bottom Physician Group Inc. | |
|
1200 Pecan St Se Washington DC 20032-2652 | |
| (771) 444-6146 | |
| Not Available |
| Full Name | Foggy Bottom Physician Group Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1200 Pecan St Se, Washington, District Of Columbia |
| Authorized Official Name and Position | Todd Evans (VP) |
| Authorized Official Contact | 6103824422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foggy Bottom Physician Group Inc. 367 S Gulph Rd King Of Prussia PA 19406-3121 Ph: (610) 382-4422 | Foggy Bottom Physician Group Inc. 1200 Pecan St Se Washington DC 20032-2652 Ph: (771) 444-6146 |
| NPI Number | 1831089846 |
|---|---|
| Provider Enumeration Date | 07/09/2025 |
| Last Update Date | 03/30/2026 |
| Certification Date | 03/30/2026 |
| Medicare PECOS PAC ID | 0042714271 |
|---|---|
| Medicare Enrollment ID | O20250919000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831089846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Jennifer Keller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841491156 PECOS PAC ID: 3274625975 Enrollment ID: I20070827000370 |
| Provider Name | Bruno P Petinaux |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558347930 PECOS PAC ID: 6305034562 Enrollment ID: I20110103000871 |
| Provider Name | Babak Sarani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942246814 PECOS PAC ID: 0547299349 Enrollment ID: I20111107000746 |
| Provider Name | Amr M Madkour |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215195532 PECOS PAC ID: 6406000157 Enrollment ID: I20130204000458 |
| Provider Name | Nephthalie Smith |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992134639 PECOS PAC ID: 3971733676 Enrollment ID: I20160419000385 |
| Provider Name | Marcus L Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962813840 PECOS PAC ID: 0547489908 Enrollment ID: I20190919001512 |
| Provider Name | Joel Willis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205169760 PECOS PAC ID: 1355488263 Enrollment ID: I20191209002375 |
| Provider Name | Ilan Breit |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104201201 PECOS PAC ID: 5395029755 Enrollment ID: I20200224001623 |
| Provider Name | Emmeline Sophia Ha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912404096 PECOS PAC ID: 4284031881 Enrollment ID: I20210924000343 |
| Provider Name | Nardos Temesgen |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1508250424 PECOS PAC ID: 8224327820 Enrollment ID: I20220702000060 |
| Provider Name | Ariana Munger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164981213 PECOS PAC ID: 4880936095 Enrollment ID: I20231009001435 |
| Provider Name | Paula M Latortue Albino |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962866822 PECOS PAC ID: 9537455829 Enrollment ID: I20231011003031 |
| Provider Name | Christopher Wanka |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942967856 PECOS PAC ID: 8325495427 Enrollment ID: I20231110002845 |
| Provider Name | Ellen Curtin Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003443409 PECOS PAC ID: 0143751339 Enrollment ID: I20240927003218 |
| Provider Name | Aerial Petty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427637727 PECOS PAC ID: 3476089129 Enrollment ID: I20241205001146 |
| Provider Name | Brittney Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811624323 PECOS PAC ID: 7214303106 Enrollment ID: I20250827003335 |
| Provider Name | Garrett S Kneese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912643255 PECOS PAC ID: 8123523040 Enrollment ID: I20250923002385 |
| Provider Name | Aixa Garland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871307306 PECOS PAC ID: 9830694900 Enrollment ID: I20250929000568 |
| Provider Name | Brenna Kelsey Lloyd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255195871 PECOS PAC ID: 4789175712 Enrollment ID: I20251118000390 |
| Provider Name | Malik Mohammad Ghawanmeh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285293498 PECOS PAC ID: 5294229829 Enrollment ID: I20251211001025 |
| Provider Name | Ronit Zelivinski |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1689254971 PECOS PAC ID: 7315423738 Enrollment ID: I20260115000797 |
| Provider Name | Tamar Virtelle Lan Walker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205396397 PECOS PAC ID: 3779810809 Enrollment ID: I20260116000014 |
| Provider Name | Kathryn Hughes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225017296 PECOS PAC ID: 3577452382 Enrollment ID: I20260116003421 |
| Provider Name | Catherine Rault |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497319602 PECOS PAC ID: 4981933199 Enrollment ID: I20260312001437 |
| Provider Name | Bryan D Hubbard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447305438 PECOS PAC ID: 5698856201 Enrollment ID: I20260327001826 |
| Provider Name | Prabhleen K Pandher |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437868759 PECOS PAC ID: 4385015106 Enrollment ID: I20260507001663 |
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