SPECIALTY PHYSICIANS OF NORTHERN VIRGINIA, LLC (NPI# 1114157054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114157054 |
| Entity Type | Organization |
| Organization Name | SPECIALTY PHYSICIANS OF NORTHERN VIRGINIA, LLC |
| Practice Address |
1850 Town Center Pkwy Suite 331 Reston VA 20190-3219 |
| Mailing Address |
1860 Town Center Dr Ste 440 Reston VA 20190-5896 |
| Practice Telephone | 7034358700 |
| Practice Fax Number | 8667434004 |
| Mailing Telephone | 7034358700 |
| Mailing Fax Number | 8667434004 |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2015-02-11 |
| Authorized Official Name | BENJAMIN CALKINS (VP) |
| Authorized Official Telephone | 8042377760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1114157054 | 05 |
| Street Address |
1850 TOWN CENTER PKWY SUITE 331 |
| City | RESTON |
| State | VA |
| Zip Code | 20190-3219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386646420 | Robert A. Shor | Internal Medicine | 1850 Town Center Pkwy, Ste 550, Reston, VA 20190-3219 | 2005-06-01 |
| 1295357507 | Karina Manicka | Registered Nurse | 1850 Town Center Pkwy, Reston, VA 20190-3204 | 2020-05-08 |
| 1134777964 | Sharon Kim | Nurse Practitioner | 1850 Town Center Pkwy, Reston, VA 20190-3204 | 2019-08-26 |
| 1538650999 | Reston Hospital Center, LLC | Rehabilitation Unit | 1850 Town Center Pkwy, Reston, VA 20190-3219 | 2018-05-22 |
| 1437656014 | Rithika Mohan | Nurse Anesthetist, Certified Registered | 1850 Town Center Pkwy, Reston, VA 20190 | 2018-04-10 |
| 1447753223 | Cara Elizabeth Butler | Registered Nurse | 1850 Town Center Pkwy, Reston, VA 20190-3219 | 2018-03-17 |
| 1669974101 | Rachel Ellenbogen | Physician Assistant | 1850 Town Center Pkwy, Reston, VA 20190-3204 | 2018-02-28 |
| 1669972626 | Meghan Squier | Nurse Anesthetist, Certified Registered | 1850 Town Center Pkwy, Reston, VA 20190-3219 | 2018-02-16 |
| 1316470198 | Dana Alsaadi | Internal Medicine | 1850 Town Center Pkwy, Reston, VA 20190-3298 | 2017-04-07 |
| 1548617863 | Reston Hospital Center, LLC | Radiologic Technologist | 1850 Town Center Pkwy, Reston, VA 20190-3219 | 2016-05-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912548470 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1906 Reston Metro Plaza, Suite 100, Reston, VA 20190 | 2019-10-04 |
| 1205483260 | Northern Virginia Applied Behavior Analysis, L.L.C. | Behavioral Analyst | 1984 Issac Newton Square West, Suite 204, Reston, VA 20190 | 2019-08-23 |
| 1336796481 | Sandra Chiunda | Nurse Practitioner | 11484 Washington Plaza W 3rd Floor, Reston, VA 20190 | 2019-08-23 |
| 1891357232 | Beyond Counseling, Inc. | Clinic/Center | 11250 Roger Bacon Dr., Atrium 5, Reston, VA 20190 | 2019-07-06 |
| 1003470063 | Sarah Katharina Jungnitsch | Registered Nurse | Reston Anesthesia Associates, 11341 Sunset Hills Road, Reston, VA 20190 | 2019-04-25 |
| 1194202341 | May Health Care Services Inc | Home Health | 12110 Sunset Hills Road Suite 600, Reston, VA 20190 | 2018-07-20 |
| 1245739895 | Carlee B. Genung | Physician Assistant | 1760 Reston Parkway Suite 306, Reston, VA 20190 | 2018-02-09 |
| 1760901045 | Kristen Kelly | Dietitian, Registered | 11703 Bowman Green Drive, Lower Level, Reston, VA 20190 | 2017-09-18 |
| 1245778992 | Sarah Christine Bernstein | Occupational Therapist | 1860 Town Center Drive Ste, Suite 300, Reston, VA 20190 | 2017-02-02 |
| 1023495298 | Phillip Nguyen | Dentist | 1800 Town Center Dr Ste 116, Reston, VA 20190 | 2015-04-27 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306187323 | Juan A Trinidad Md PC | Surgery | 1800 Town Center Dr Ste 310, Reston, VA 20190-3215 | 2013-03-15 |
| 1265565626 | Elizabeth D Feldman | Surgery | 1860 Town Center Dr Ste 460, Reston, VA 20190-5901 | 2007-03-14 |
| 1891824678 | Pinnar Surgical Associates, Ltd | Surgery | 1850 Town Center Pkwy # 301, Reston, VA 20190-3219 | 2007-03-05 |
| 1366489098 | Matthew A Fitzer | Surgery | 1850a Town Center Pkwy, Suite 301, Reston, VA 20190-5851 | 2006-06-01 |
| 1326098997 | De Quang Tran | Surgery | 11509 Ivy Bush Ct, Reston, VA 20191-2262 | 2006-05-12 |
| 1841550035 | Virginia Bariatric Surgery P.C. | Surgery | 1850a Town Center Pkwy, Suite 301, Reston, VA 20190-5851 | 2012-05-21 |
| 1740560135 | Quantumbariatrics LLC | Surgery | 11335 Sunset Hills Rd, Reston, VA 20190-5205 | 2011-08-17 |
| 1649563099 | Synchrony Health Virginia | Surgery | 1850 Town Center Pkwy, 303, Reston, VA 20190-3219 | 2011-05-18 |
| 1649597337 | Gonzalo Romero, Md PC | Surgery | 1860 Town Center Dr., Suite 350, Reston, VA 20190-5912 | 2010-04-21 |
| 1376763995 | Keyur Shah, M.d., P.C. | Surgery | 1800 Town Center Dr, Suite 218, Reston, VA 20190-3215 | 2007-04-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.