Colleen Grace Renzi, PA-C
Physician Assistant, Surgical in North Bethesda, MD. Individual provider (NPI-1).
NPI number1154740322
StatusActive
Last updated in NPPESApr 15, 2014
Details
- NPI
- 1154740322
- Entity type
- Individual (NPI-1)
- Name
- Colleen Grace Renzi
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 15, 2014
- Last updated
- Apr 15, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | C0005337 | MD | Yes |
Practice location
11601 Split Rail CtNorth Bethesda, MD 20852-4423
Phone 301-467-5443
Mailing address
9901 Medical Center DrRockville, MD 20850-3357
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