| Ashby Ponds Medical Center | |
|
21170 Ashby Ponds Blvd Ashburn VA 20147 | |
| (571) 291-6131 | |
| (571) 291-6135 |
| Full Name | Ashby Ponds Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 21170 Ashby Ponds Blvd, Ashburn, Virginia |
| Authorized Official Name and Position | Matthew J Narrett (SENIOR VP AND CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 4104022257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashby Ponds Medical Center 5730 Executive Dr Ste 230 Catonsville MD 21228-1762 Ph: (571) 291-6131 | Ashby Ponds Medical Center 21170 Ashby Ponds Blvd Ashburn VA 20147 Ph: (571) 291-6131 |
| NPI Number | 1871759340 |
|---|---|
| Provider Enumeration Date | 08/04/2008 |
| Last Update Date | 08/10/2023 |
| Medicare PECOS PAC ID | 1153314067 |
|---|---|
| Medicare Enrollment ID | O20090310000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871759340 | NPI | - | NPPES |
| Provider Name | Thomas J Mancini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568456275 PECOS PAC ID: 4688629595 Enrollment ID: I20050314000791 |
| Provider Name | Vijaya L Sunkara |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871548255 PECOS PAC ID: 5294784583 Enrollment ID: I20060829000383 |
| Provider Name | Shaveta Kotwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841492733 PECOS PAC ID: 2163588500 Enrollment ID: I20090310000106 |
| Provider Name | Gauthami Gondy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992963144 PECOS PAC ID: 0143370544 Enrollment ID: I20090605000157 |
| Provider Name | Thomas F Morris |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1326056045 PECOS PAC ID: 6901861251 Enrollment ID: I20120301000940 |
| Provider Name | Rebekah Hannay Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659618049 PECOS PAC ID: 6002051935 Enrollment ID: I20130326000258 |
| Provider Name | Jose Noel P Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992925671 PECOS PAC ID: 9931320744 Enrollment ID: I20141020002824 |
| Provider Name | Stephanie Jo Megregian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386186492 PECOS PAC ID: 1658652813 Enrollment ID: I20170111001650 |
| Provider Name | Ronald P Longo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710423306 PECOS PAC ID: 5698049641 Enrollment ID: I20180219001029 |
| Provider Name | Ehsan A Khan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1598149734 PECOS PAC ID: 5991059230 Enrollment ID: I20181126001996 |
| Provider Name | Matthew J Keast |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1376505842 PECOS PAC ID: 6305743451 Enrollment ID: I20230209002582 |
| Provider Name | Peter Harding |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992783260 PECOS PAC ID: 1951492016 Enrollment ID: I20230306002801 |
| Provider Name | Kauser Kaleem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073025375 PECOS PAC ID: 6103171764 Enrollment ID: I20230808001242 |
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