| Advanced Digestive Care, Llc | |
|
3301 Woodburn Rd Ste 107 Annandale VA 22003-1297 | |
| (703) 876-0437 | |
| (703) 876-0722 |
| Full Name | Advanced Digestive Care, Llc |
|---|---|
| Speciality | Pathology |
| Location | 3301 Woodburn Rd Ste 107, Annandale, Virginia |
| Authorized Official Name and Position | Martin G Prosky (ADMINISTRATOR) |
| Authorized Official Contact | 7034077216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Digestive Care, Llc 3301 Woodburn Rd Ste 107 Annandale VA 22003-1297 Ph: (703) 876-0437 | Advanced Digestive Care, Llc 3301 Woodburn Rd Ste 107 Annandale VA 22003-1297 Ph: (703) 876-0437 |
| NPI Number | 1629462171 |
|---|---|
| Provider Enumeration Date | 03/23/2015 |
| Last Update Date | 06/05/2023 |
| Medicare PECOS PAC ID | 3375857725 |
|---|---|
| Medicare Enrollment ID | O20150730010749 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629462171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 207ZP0105X | Pathology - Clinical Pathology/laboratory Medicine | (* (Not Available)) | Primary |
| Provider Name | Vicki A Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487656898 PECOS PAC ID: 6800889783 Enrollment ID: I20040406001273 |
| Provider Name | Jack C Huang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003802380 PECOS PAC ID: 8628051455 Enrollment ID: I20040611000278 |
| Provider Name | Claudine H Desamours |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205920246 PECOS PAC ID: 0648171538 Enrollment ID: I20050728000450 |
| Provider Name | Darren S Baroni |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154377497 PECOS PAC ID: 4385648138 Enrollment ID: I20060908000369 |
| Provider Name | Nina Phatak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093828147 PECOS PAC ID: 2466467766 Enrollment ID: I20061201000072 |
| Provider Name | Myung Choi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023057445 PECOS PAC ID: 0749220853 Enrollment ID: I20061207000331 |
| Provider Name | Rehaan M Ahsan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558436733 PECOS PAC ID: 1052216397 Enrollment ID: I20070209000043 |
| Provider Name | James A Henry |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1619954351 PECOS PAC ID: 9931131489 Enrollment ID: I20080114000338 |
| Provider Name | Caroline C Madison |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912183211 PECOS PAC ID: 4688750730 Enrollment ID: I20080328000726 |
| Provider Name | Paul O Arnold |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992828693 PECOS PAC ID: 4789741810 Enrollment ID: I20090330000392 |
| Provider Name | Ghazaleh Aram |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154499069 PECOS PAC ID: 5597814962 Enrollment ID: I20090514000571 |
| Provider Name | Jerome T Oconnell |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1861516718 PECOS PAC ID: 0042403461 Enrollment ID: I20101019000083 |
| Provider Name | Joel Alfiler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942304514 PECOS PAC ID: 9739374729 Enrollment ID: I20101116001068 |
| Provider Name | Rakesh Shah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851495428 PECOS PAC ID: 2769588045 Enrollment ID: I20101208001291 |
| Provider Name | Edward C Kim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275538076 PECOS PAC ID: 2466470265 Enrollment ID: I20110215001133 |
| Provider Name | Crystal Mcgovern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063714244 PECOS PAC ID: 9032394366 Enrollment ID: I20110429000428 |
| Provider Name | Michael Brown |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861488637 PECOS PAC ID: 3971551938 Enrollment ID: I20110510000920 |
| Provider Name | Atul V Marathe |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326034695 PECOS PAC ID: 6800852310 Enrollment ID: I20110513000173 |
| Provider Name | Kenneth N Josovitz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922094580 PECOS PAC ID: 1759364573 Enrollment ID: I20110524000054 |
| Provider Name | Alexander K Eitel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093739849 PECOS PAC ID: 4688676679 Enrollment ID: I20110613000598 |
| Provider Name | Jin H Park |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225033038 PECOS PAC ID: 3274532221 Enrollment ID: I20110808000012 |
| Provider Name | Prasadarao S Velugubanti |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477584910 PECOS PAC ID: 1951491018 Enrollment ID: I20111019000238 |
| Provider Name | Anisha Thadani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346403920 PECOS PAC ID: 7810157443 Enrollment ID: I20120320000011 |
| Provider Name | Tinatin Khizanishvili O Connell |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720253503 PECOS PAC ID: 3971766353 Enrollment ID: I20120522001182 |
| Provider Name | Jayme R Tishon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417123829 PECOS PAC ID: 8123275799 Enrollment ID: I20120904000664 |
| Provider Name | Radha Menon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427218122 PECOS PAC ID: 1456502699 Enrollment ID: I20121115000295 |
| Provider Name | Sarah Brady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316297591 PECOS PAC ID: 8123279130 Enrollment ID: I20121120000531 |
| Provider Name | Benjamin E Young |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326205113 PECOS PAC ID: 6204090566 Enrollment ID: I20130520000005 |
| Provider Name | Narayan Dharel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942464102 PECOS PAC ID: 2163599101 Enrollment ID: I20130621000139 |
| Provider Name | Jennifer S Teifer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639263866 PECOS PAC ID: 4385646058 Enrollment ID: I20131203002217 |
| Provider Name | Frank Procaccino |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477658193 PECOS PAC ID: 2860679172 Enrollment ID: I20140317000874 |
| Provider Name | Rizwan Ahmed |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841469061 PECOS PAC ID: 6002972023 Enrollment ID: I20140814002481 |
| Provider Name | Melissa S Mehiel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255729372 PECOS PAC ID: 8527385673 Enrollment ID: I20150330000423 |
| Provider Name | Claire Jenkins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265478580 PECOS PAC ID: 1557343720 Enrollment ID: I20150528002819 |
| Provider Name | Linda A Myers |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609960293 PECOS PAC ID: 1951347251 Enrollment ID: I20150617002488 |
| Provider Name | Arunan Siva Vamadevan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457546236 PECOS PAC ID: 4486975562 Enrollment ID: I20150618002985 |
| Provider Name | Ali Kazemi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609019520 PECOS PAC ID: 0244406809 Enrollment ID: I20150826000842 |
| Provider Name | Tina Polley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548657117 PECOS PAC ID: 8022320258 Enrollment ID: I20151221001637 |
| Provider Name | Ramsey Daher |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710206115 PECOS PAC ID: 3072807056 Enrollment ID: I20160815001203 |
| Provider Name | Mylan Ravi Satchi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629269527 PECOS PAC ID: 4284898115 Enrollment ID: I20170713002737 |
| Provider Name | Nicholas Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477872158 PECOS PAC ID: 9133499155 Enrollment ID: I20170920000460 |
| Provider Name | Milan Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043537335 PECOS PAC ID: 7315230851 Enrollment ID: I20170928001564 |
| Provider Name | Kibbum Kang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548502347 PECOS PAC ID: 7113147604 Enrollment ID: I20181114001685 |
Trang T. Vo-nguyen, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6800 Little River Tpke, Annandale, VA 22003 Phone: 703-750-6800 Fax: 703-354-4501 | |
Lewis Family Medicine, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4307 Kenwyn Ct, Annandale, VA 22003 Phone: 703-598-0262 | |
Imc Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7535 Little River Tpke, Suite 100c, Annandale, VA 22003 Phone: 703-642-1004 Fax: 703-642-3232 | |
Neighborhood Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6715 Little River Tpke Ste 201, Annandale, VA 22003 Phone: 703-535-5568 | |
Peter D Kim Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4208 Evergreen Ln, Suite 222, Annandale, VA 22003 Phone: 703-642-2288 Fax: 703-642-1224 | |
Bao Dinh Do Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3301 Woodburn Rd Ste 311, Annandale, VA 22003 Phone: 703-828-0048 Fax: 703-574-8649 | |
Nova Training Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4231 Markham St Ste 224, Annandale, VA 22003 Phone: 703-266-2220 |