NICOL RENEE AWADALLA BACON MD
NPI 1104062454
Pediatrics - Developmental - Behavioral Pediatrics in Washington, DC

Q: What is Nicol Awadalla Bacon's NPI number?

The NPI number for Nicol Awadalla Bacon is 1104062454. It was assigned to this individual provider in the NPPES registry on December 16, 2008.

Q: What is Nicol Awadalla Bacon's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Active since December 16, 2008PECOS Enrolled

111 MICHIGAN AVE NW, WASHINGTON, DC 20010(202) 476-5000 Get Directions Write a Review

NPPES record last updated: October 18, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Nicol Renee Awadalla Bacon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOL RENEE AWADALLA BACON MD (NPI 1104062454) is an individual developmental - behavioral pediatrics provider in Washington, District Of Columbia, licensed in District Of Columbia (MD046588) and active in the NPI registry since December 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104062454

Entity TypeIndividualFemale

Primary Taxonomy2080P0006X

Provider Legal NameNICOL RENEE AWADALLA BACONCredential: MD

Location Address111 MICHIGAN AVE NWWashington, DC 20010-2916

Mailing AddressPo Box 37215Baltimore, MD 21297-3215 · (202) 476-5000

Phone(202) 476-5000

Sole ProprietorNo

Enumeration DateDecember 16, 2008

Last NPPES UpdateOctober 18, 2018

✔ NPI 1104062454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians

Taxonomy Code2080P0006X

License✔ Licensed in DC · MD046588

Definition

A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.

111 MICHIGAN AVE NW, Washington, DC 20010

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicol Renee Awadalla Bacon Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREA BADILLO MD

Surgery

111 MICHIGAN AVE NW
WASHINGTON, DC 20010

District of Columbia (202) 476-2451

DR. TALITA MICHELLE JORDAN MD

Pediatrics

111 MICHIGAN AVE NW
WASHINGTON, DC 20010

District of Columbia (202) 476-5000

YUE-HIN LOKE MD

Pediatrics (Pediatric Cardiology)

111 MICHIGAN AVE NW, W3.5, 600
WASHINGTON, DC 20010

District of Columbia (202) 476-3670

ELSHADEY YAYEHYERADE BEKELE

Pediatrics

111 MICHIGAN AVE NW
WASHINGTON, DC 20010

District of Columbia (301) 565-4279

NOURA AL DHAHERI MD

Student in an Organized Health Care Education/Training Program

111 MICHIGAN AVE NW, W3.5, 600
WASHINGTON, DC 20010

District of Columbia (202) 476-3670

JIA LIU MD

Anesthesiology (Pediatric Anesthesiology)

111 MICHIGAN AVE NW
WASHINGTON, DC 20010

District of Columbia (202) 476-5000

DR. CHARLES JOHN BILLINGTON JR. MD

Medical Genetics (Clinical Genetics (M.D.))

111 MICHIGAN AVE NW, W3.5, 600
WASHINGTON, DC 20010

District of Columbia (202) 476-3670

GINA JIN LEE PHARMD

Pharmacist (Pharmacotherapy)

111 MICHIGAN AVE NW
WASHINGTON, DC 20010

District of Columbia (202) 476-4080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicol Awadalla Bacon's NPI number?

The NPI number for Nicol Awadalla Bacon is 1104062454. It was assigned to this individual provider in the NPPES registry on December 16, 2008.

Where is Nicol Awadalla Bacon located?

Nicol Awadalla Bacon practices at 111 Michigan Ave NW, Washington, DC 20010. The listed phone number is (202) 476-5000.

What is Nicol Awadalla Bacon's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Is Nicol Awadalla Bacon enrolled in Medicare?

Yes. Nicol Awadalla Bacon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicol Awadalla Bacon was last updated on October 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.