DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) – Nurse Practitioner, NPI 1649098591

DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) is a healthcare provider. based in Rockville, Maryland. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP, CRNP, AGNP-C. They hold a License No. R217568 (MD). The NPI Number for DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) is 1649098591

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C)
NPI
1649098591
Phone
(301) 762-7723
Address
50 W EDMONSTON DR STE 404
Enumeration Date
30 September 2024
Last Update Date
30 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3017627723
Graduation Year
2024 (2 years ago)
PAC ID
1557896362
Group Practice PAC ID
7113343443
Professional Enrollment ID
I20241203000142
Address ID
MD208521274RO50XXXDRXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

6,767 NURSE PRACTITIONER in MD

Provider Addresses for DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C)

  • 50 W EDMONSTON DR STE 404

    ROCKVILLE, MD 208521274

    Phone: (301) 762-7723

    Type: Mailing

  • 22 S Greene St

    Baltimore, MD 212011544

    Phone: (410) 328-8667

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241203000142INurse PractitionerDCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 20852)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113343443View full group profile
NameSpecialtyState
Nurse PractitionerMD
Physician AssistantNC
Internal MedicineMD
Nurse PractitionerMD
Physician Assistant, Internal MedicineMD
Nurse PractitionerMD
Family PracticeDC
Physician AssistantNJ
Nurse PractitionerMD
Physician AssistantVA

Reviews

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Frequently asked questions

Does DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) have a public NPI I can cite?
Public records show DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) under NPI 1649098591.
Should I treat DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) as an active provider?
Patients and plans typically see DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) as active in the national extract.
What does the directory say DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) does?
Insurance directories may phrase it differently, but here DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) maps to Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C)?
DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C) is associated with Rockville, Maryland in the same public data insurers reference.
Can I export DR. FAMATTA AJAVON (DNP, CRNP, AGNP-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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