Individual provider Active NPI

Betsy Vasquez, M.D.

  • Pediatric Otolaryngology Physician
  • Sterling, VA
National Provider Identifier
1003995168
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
0101052517 Issued in VA
Practice address
46090 Lake Center PLZ Ste 104
Sterling, VA 20165-5877
Phone
(703) 421-1700
Fax
(703) 421-5550
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 0101052517 VA Primary

Addresses

Primary practice location

46090 Lake Center PLZ Ste 104
Sterling, VA 20165-5877

Mailing address

46090 Lake Center PLZ Ste 104
Sterling, VA 20165-5877
Phone (703) 421-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041027000388 VA Practitioner - Otolaryngology 7315909942 Reassigns benefits to 1 organization
I20161219002110 DC Practitioner - Otolaryngology 7315909942 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101052517VAMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Nov 17, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 17, 2016 Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

8644 Sudley Rd
#220
Manassas, VA 20110

46090 Lake Center Plz
Ste 104
Sterling, VA 20165
Phone (703) 229-2544

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003995168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46090 LAKE CENTER PLZ STE 104",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655877",
            "telephone_number": "703-421-1700",
            "fax_number": "703-421-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46090 LAKE CENTER PLZ STE 104",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655877",
            "telephone_number": "703-421-1700",
            "fax_number": "703-421-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "BETSY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "VA",
            "license": "0101052517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

Verify at the official NPI Registry.