Gastroenterology Associates Of Northern Virginia, Llc | |
3700 Joseph Siewick Dr. Suite 308 Fairfax VA 22033-1739 | |
(703) 716-8700 | |
(703) 716-8703 |
Full Name | Gastroenterology Associates Of Northern Virginia, Llc |
---|---|
Speciality | Internal Medicine |
Location | 3700 Joseph Siewick Dr., Fairfax, Virginia |
Authorized Official Name and Position | Tonya Adams (VICE PRESIDENT) |
Authorized Official Contact | 7036988960 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Gastroenterology Associates Of Northern Virginia, Llc 3700 Joseph Siewick Dr. Suite 308 Fairfax VA 22033-1739 Ph: (703) 716-8700 | Gastroenterology Associates Of Northern Virginia, Llc 3700 Joseph Siewick Dr. Suite 308 Fairfax VA 22033-1739 Ph: (703) 716-8700 |
NPI Number | 1205884368 |
---|---|
Provider Enumeration Date | 05/04/2006 |
Last Update Date | 12/20/2019 |
Medicare PECOS PAC ID | 1759371008 |
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Medicare Enrollment ID | O20040517001478 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205884368 | NPI | - | NPPES |
178704 | Other | VA | ANTHEM BCBS |
104411 | Other | KAISER | |
7916 | Other | CAREFIRST BCBS | |
CD8396 | Other | VA | RAILROAD MEDICARE |
3810003805 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
2080P0206X | Pediatrics - Pediatric Gastroenterology | (* (Not Available)) | Secondary |
Provider Name | Nader H 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 | Mahmood Abedi |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1649255233 PECOS PAC ID: 5193783264 Enrollment ID: I20041221000972 |
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 | Behzad Kalaghchi |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1356337158 PECOS PAC ID: 2466412739 Enrollment ID: I20050223000933 |
Provider Name | Emil Valle |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1497711238 PECOS PAC ID: 5395734354 Enrollment ID: I20050510000634 |
Provider Name | Mohammad H Razavi |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1639167661 PECOS PAC ID: 9537114343 Enrollment ID: I20050909000162 |
Provider Name | Waseem Ismail Aziz |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1023038270 PECOS PAC ID: 9436184116 Enrollment ID: I20050930000617 |
Provider Name | Shilen Lakhani |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1871503599 PECOS PAC ID: 3678596558 Enrollment ID: I20060105000805 |
Provider Name | Jeremias C Tan |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1699723213 PECOS PAC ID: 2860405628 Enrollment ID: I20060720000241 |
Provider Name | James A Henry |
---|---|
Provider Type | Practitioner - Pathology |
Provider Identifiers | NPI Number: 1619954351 PECOS PAC ID: 9931131489 Enrollment ID: I20061011000764 |
Provider Name | Ahmed M Hegab |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1699793372 PECOS PAC ID: 4486603099 Enrollment ID: I20070316000072 |
Provider Name | Sandeep Bagla |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1689718611 PECOS PAC ID: 9739280132 Enrollment ID: I20070730000620 |
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 | Mu K Hong |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1346251196 PECOS PAC ID: 8022144294 Enrollment ID: I20100326000350 |
Provider Name | Rupa N Shah |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1740209147 PECOS PAC ID: 9234160466 Enrollment ID: I20100608000813 |
Provider Name | Carol S Schuffler |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1598800765 PECOS PAC ID: 6305034471 Enrollment ID: I20101216000648 |
Provider Name | Jerome T Oconnell |
---|---|
Provider Type | Practitioner - Pathology |
Provider Identifiers | NPI Number: 1861516718 PECOS PAC ID: 0042403461 Enrollment ID: I20110315000409 |
Provider Name | Peter Scudera |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1063488575 PECOS PAC ID: 9133145477 Enrollment ID: I20110330000301 |
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 | Byungki Kim |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1255307906 PECOS PAC ID: 0446277040 Enrollment ID: I20110523000307 |
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 | Nitin K Sardana |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1760648059 PECOS PAC ID: 7214106509 Enrollment ID: I20110802000626 |
Provider Name | Minal Patel |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1588848089 PECOS PAC ID: 5890966337 Enrollment ID: I20110914000268 |
Provider Name | Amy G. Shah |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1093923757 PECOS PAC ID: 3476709650 Enrollment ID: I20120817000149 |
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 | 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 | 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 | Rachel L Piechowiak |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1679867212 PECOS PAC ID: 5092961029 Enrollment ID: I20161018002612 |
Provider Name | Nicholas Wilson |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1477872158 PECOS PAC ID: 9133499155 Enrollment ID: I20170725001788 |
Provider Name | Jared Sharp |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306365507 PECOS PAC ID: 8729340096 Enrollment ID: I20180326002869 |
Provider Name | Nicole L Dease |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972167666 PECOS PAC ID: 2769818228 Enrollment ID: I20200203000417 |
Provider Name | Rahul Kataria |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1538401831 PECOS PAC ID: 0547557118 Enrollment ID: I20200831002594 |
Provider Name | Mohamed A Sultan |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1831320571 PECOS PAC ID: 5092021832 Enrollment ID: I20201111000193 |
Provider Name | Brittany A Stivers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720612294 PECOS PAC ID: 2567875263 Enrollment ID: I20210209000226 |
Provider Name | Vishant Ramadorai |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1467848473 PECOS PAC ID: 6507173275 Enrollment ID: I20210707003218 |
Provider Name | Javelle A Wynter |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1659799906 PECOS PAC ID: 2769604263 Enrollment ID: I20210709002252 |
Provider Name | Joel Andrew Wolf |
---|---|
Provider Type | Practitioner - Interventional Radiology |
Provider Identifiers | NPI Number: 1306233911 PECOS PAC ID: 3072916204 Enrollment ID: I20210727000106 |
Provider Name | Jessica Trevino |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1912946484 PECOS PAC ID: 8426240755 Enrollment ID: I20210908000111 |
Provider Name | Alex Pavidapha |
---|---|
Provider Type | Practitioner - Interventional Radiology |
Provider Identifiers | NPI Number: 1053799585 PECOS PAC ID: 2769774801 Enrollment ID: I20220211001177 |
Provider Name | Christine Nicole Garcia |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639658875 PECOS PAC ID: 7012255359 Enrollment ID: I20220525001119 |
Provider Name | Monica Passi |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1568859031 PECOS PAC ID: 3274870274 Enrollment ID: I20220607003409 |
Provider Name | Courtney Marie Worner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720759673 PECOS PAC ID: 1557756038 Enrollment ID: I20220608003147 |
Provider Name | Susan M Zemitis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093483505 PECOS PAC ID: 2062895873 Enrollment ID: I20220811001332 |
Provider Name | Claudine Morcos |
---|---|
Provider Type | Practitioner - Pathology |
Provider Identifiers | NPI Number: 1629206610 PECOS PAC ID: 4880860287 Enrollment ID: I20220923000453 |
Provider Name | Arun Reddy Mannem |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1871721019 PECOS PAC ID: 7810143310 Enrollment ID: I20220930002485 |
Provider Name | Emily Munro Christman |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1083677199 PECOS PAC ID: 6709042930 Enrollment ID: I20221003000094 |
Provider Name | David Balaban |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1225035959 PECOS PAC ID: 2163553157 Enrollment ID: I20221003003002 |
Provider Name | Catherine Easter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881647444 PECOS PAC ID: 2961580246 Enrollment ID: I20221012000815 |
Provider Name | Donna Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396744231 PECOS PAC ID: 3779660667 Enrollment ID: I20221012001027 |
Provider Name | Amy Mcdonnell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770582702 PECOS PAC ID: 5496840936 Enrollment ID: I20221013001339 |
Provider Name | Daniel John Pambianco |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1760489488 PECOS PAC ID: 4587795562 Enrollment ID: I20221013002060 |
Provider Name | Elliot Smith |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1548559081 PECOS PAC ID: 9537398375 Enrollment ID: I20221102000035 |
Provider Name | Caroline Eri Hong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700352382 PECOS PAC ID: 4385012129 Enrollment ID: I20221129003088 |
Provider Name | Molly Anne Asper |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992422711 PECOS PAC ID: 6002285533 Enrollment ID: I20221206000514 |
Provider Name | Diego Alonso Gomez |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1003815408 PECOS PAC ID: 4183755283 Enrollment ID: I20221207002868 |
Provider Name | Sylvia Satiyaselan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033846225 PECOS PAC ID: 9032581954 Enrollment ID: I20230209002991 |
Provider Name | Michelle K Wrieden |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790475879 PECOS PAC ID: 8426407156 Enrollment ID: I20231208002961 |
Provider Name | Ali Asif Khan |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1801320957 PECOS PAC ID: 7416229463 Enrollment ID: I20240108005035 |
Provider Name | Hina Qureshi |
---|---|
Provider Type | Practitioner - Pathology |
Provider Identifiers | NPI Number: 1568488286 PECOS PAC ID: 7517150071 Enrollment ID: I20240117002359 |
Provider Name | Muhammad Khokhar |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1033145586 PECOS PAC ID: 6406868868 Enrollment ID: I20240123003850 |
Provider Name | Leah Blatzer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023667649 PECOS PAC ID: 5890118681 Enrollment ID: I20240129003070 |
Provider Name | Brian Benson |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1740574870 PECOS PAC ID: 3678887924 Enrollment ID: I20240222002798 |
Provider Name | Maja Strollo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154028009 PECOS PAC ID: 8123484755 Enrollment ID: I20240306003102 |
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