NPIMap

Individual provider Active NPI

Lavanya Nutankalva, MD

  • Infectious Disease Physician
  • Reston, VA
National Provider Identifier
1003997339
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
01077934 Issued in IN
Practice address
1860 Town Center Dr Ste 310
Reston, VA 20190-5899
Phone
(703) 738-9989
Fax
(703) 738-9991
NPI assigned
Oct 17, 2006
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 01077934 IN Primary
Infectious Disease Physician 207RI0200X MD034555 DC

Addresses

Primary practice location

1860 Town Center Dr Ste 310
Reston, VA 20190-5899

Mailing address

4437 Brookfield Corporate Dr Ste 101
Chantilly, VA 20151-2122
Phone (703) 738-9989

Other identifiers 3

IdentifierTypeStateIssuer
010176531MedicaidVA
036829400MedicaidDC
408044100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050811000974 DC Practitioner - Infectious Disease 7012946734 Reassigns benefits to 1 organization
I20190104001943 VA Practitioner - Infectious Disease 7012946734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1860 Town Ctr Dr
Suite 310
Reston, VA 20190-5899

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.74 of 100Reported as individual
Quality
69
Improvement activities
40
Cost
80.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01077934INMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Id Doctors LLC Infectious Disease CurrentSince Sep 16, 2016 Accepting new patients
Howard University Past Accepting new patients

Locations

4437 Brookfield Corporate Dr
Ste 101
Chantilly, VA 20151

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

1860 Town Center Dr
Ste 310
Reston, VA 20190
Phone (703) 435-0700

24430 Millstream Dr
Stone Ridge, VA 20105
Phone (703) 957-2000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCJADD
  • FHIR API: https://fhir4.healow.com/fhir/r4/GCJADD/Endpoint/GCJADD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1003997339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4437 BROOKFIELD CORPORATE DR STE 101",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512122",
            "telephone_number": "703-738-9989",
            "fax_number": "703-738-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR STE 310",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905899",
            "telephone_number": "703-738-9989",
            "fax_number": "703-738-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTANKALVA",
        "first_name": "LAVANYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01077934",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "DC",
            "license": "MD034555",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010176531",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036829400",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408044100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.