| 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 | O20170124002297 |
| 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 | Nader Balba |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013949254 PECOS PAC ID: 2062402308 Enrollment ID: I20040517001452 |
| Provider Name | Ronald J Barkin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477623650 PECOS PAC ID: 7012987480 Enrollment ID: I20040831001519 |
| Provider Name | Atul V Marathe |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326034695 PECOS PAC ID: 6800852310 Enrollment ID: I20041207000393 |
| Provider Name | Jack C Huang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003802380 PECOS PAC ID: 8628051455 Enrollment ID: I20041207000408 |
| Provider Name | Kenneth N Josovitz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922094580 PECOS PAC ID: 1759364573 Enrollment ID: I20041207000425 |
| Provider Name | Claudine H Desamours |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205920246 PECOS PAC ID: 0648171538 Enrollment ID: I20041220000791 |
| Provider Name | Michael Brown |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861488637 PECOS PAC ID: 3971551938 Enrollment ID: I20050107000056 |
| Provider Name | Eduardo Noguera |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295791176 PECOS PAC ID: 0446209514 Enrollment ID: I20050114000679 |
| Provider Name | Emil Valle |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497711238 PECOS PAC ID: 5395734354 Enrollment ID: I20050510000634 |
| Provider Name | Robert B Heaton Jr |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003817164 PECOS PAC ID: 2163447285 Enrollment ID: I20051007000658 |
| Provider Name | Shilen Lakhani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871503599 PECOS PAC ID: 3678596558 Enrollment ID: I20060105000805 |
| Provider Name | Amir Kende |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1841200896 PECOS PAC ID: 3173538972 Enrollment ID: I20060215000669 |
| Provider Name | Truc Thi Trinh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063441863 PECOS PAC ID: 4385674027 Enrollment ID: I20060717000090 |
| Provider Name | Jeremias Tan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699723213 PECOS PAC ID: 2860405628 Enrollment ID: I20060720000241 |
| Provider Name | Ahmed M Hegab |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699793372 PECOS PAC ID: 4486603099 Enrollment ID: I20070316000072 |
| Provider Name | Diego Kuperschmit |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457450280 PECOS PAC ID: 2264438241 Enrollment ID: I20071023000046 |
| Provider Name | Asma Khapra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770702011 PECOS PAC ID: 4688757594 Enrollment ID: I20080215000452 |
| Provider Name | Anita Wolke |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215993068 PECOS PAC ID: 9537122965 Enrollment ID: I20080728000009 |
| Provider Name | Gabriel B Herman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437231289 PECOS PAC ID: 6901992122 Enrollment ID: I20081217000081 |
| Provider Name | Pradeep K Gupta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215097829 PECOS PAC ID: 7416081856 Enrollment ID: I20100820000019 |
| Provider Name | Stafford S Goldstein |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144249749 PECOS PAC ID: 9335159250 Enrollment ID: I20101116000047 |
| Provider Name | Martin G Prosky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740215391 PECOS PAC ID: 0244240166 Enrollment ID: I20101116000069 |
| Provider Name | Carol S Schuffler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598800765 PECOS PAC ID: 6305034471 Enrollment ID: I20101216000648 |
| Provider Name | Myung Choi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023057445 PECOS PAC ID: 0749220853 Enrollment ID: I20110104000439 |
| Provider Name | Tonya Adams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861472862 PECOS PAC ID: 1850317199 Enrollment ID: I20110330000339 |
| Provider Name | Michael Garone |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255311189 PECOS PAC ID: 4587680822 Enrollment ID: I20110331000102 |
| Provider Name | Kenneth Mirkin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952372542 PECOS PAC ID: 4385660638 Enrollment ID: I20110429000169 |
| Provider Name | Andrew Axelrad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073579876 PECOS PAC ID: 2567563570 Enrollment ID: I20110520000688 |
| Provider Name | Suresh Kumar Malhotra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942370127 PECOS PAC ID: 9830169200 Enrollment ID: I20110603000107 |
| Provider Name | Frank Procaccino |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477658193 PECOS PAC ID: 2860679172 Enrollment ID: I20110613000728 |
| Provider Name | Alan Plotner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114983004 PECOS PAC ID: 1557462561 Enrollment ID: I20110627000508 |
| Provider Name | Srikrishna Vemana |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578771820 PECOS PAC ID: 5496947756 Enrollment ID: I20110808000202 |
| Provider Name | Minal Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588848089 PECOS PAC ID: 5890966337 Enrollment ID: I20110914000268 |
| Provider Name | Rachana Potru |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235395583 PECOS PAC ID: 5193966497 Enrollment ID: I20130730000221 |
| Provider Name | Benjamin E Young |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326205113 PECOS PAC ID: 6204090566 Enrollment ID: I20130918000233 |
| Provider Name | Anisha Thadani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346403920 PECOS PAC ID: 7810157443 Enrollment ID: I20131011000072 |
| Provider Name | Ghazaleh Aram |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154499069 PECOS PAC ID: 5597814962 Enrollment ID: I20131024000127 |
| Provider Name | Joylyn M Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962404277 PECOS PAC ID: 9032344965 Enrollment ID: I20140203000617 |
| Provider Name | Bezawit Tekola |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770742595 PECOS PAC ID: 8022246974 Enrollment ID: I20140822001853 |
| Provider Name | Felice Banson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962407924 PECOS PAC ID: 9335136191 Enrollment ID: I20141222002232 |
| Provider Name | Katie Crain Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639154099 PECOS PAC ID: 4385807395 Enrollment ID: I20150217000966 |
| Provider Name | Nina Phatak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093828147 PECOS PAC ID: 2466467766 Enrollment ID: I20150331001112 |
| Provider Name | Jin H Park |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225033038 PECOS PAC ID: 3274532221 Enrollment ID: I20150407000450 |
| Provider Name | Arunan Siva Vamadevan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457546236 PECOS PAC ID: 4486975562 Enrollment ID: I20150601001978 |
| Provider Name | Tina Polley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548657117 PECOS PAC ID: 8022320258 Enrollment ID: I20150701000536 |
| Provider Name | Ali Kazemi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609019520 PECOS PAC ID: 0244406809 Enrollment ID: I20150825004589 |
| Provider Name | Ivan Peter Harnden |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568781706 PECOS PAC ID: 0042504268 Enrollment ID: I20160811000928 |
| Provider Name | Iris Hyun Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881911667 PECOS PAC ID: 4284933490 Enrollment ID: I20160901002476 |
| Provider Name | Ramsey Daher |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710206115 PECOS PAC ID: 3072807056 Enrollment ID: I20161220000745 |
| Provider Name | Nicholas Wilson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477872158 PECOS PAC ID: 9133499155 Enrollment ID: I20170725001788 |
| Provider Name | Riad Almudallal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245220763 PECOS PAC ID: 7517862170 Enrollment ID: I20210316000002 |
| Provider Name | Amy Peng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457926222 PECOS PAC ID: 9133651086 Enrollment ID: I20241016002187 |
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 |