Jonathan Bernard Menezes, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

MD041163 Issued in DC

Practice address

1890 Metro Center Dr
Reston, VA 20190-5286

Phone

(703) 709-1500

NPI assigned

Jun 28, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 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

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pavilion Medical Home Care & Staffing, LLC Home health agency, Annandale, VA, CCN 497636
• Virginia Healthcare Services Home health agency, Annandale, VA, CCN 497605

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Lansdowne, VA
  • NPI 1861552721
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Achievement Rehabilitation Care

  • Home Health Agency
  • Fredericksburg, VA
  • NPI 1710299755
  Care Compare affiliation
• Achievement Rehabilitation Care 4PT (Arc) P.C.

  • Home Health Agency
  • Annandale, VA
  • NPI 1326063132
  Care Compare affiliation
• Pavilion Medical Home Care & Staffing, LLC

  • Home Health Agency
  • Annandale, VA
  • NPI 1376620120
  Care Compare affiliation

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1023329802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 METRO CENTER DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 METRO CENTER DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905286",
            "telephone_number": "703-709-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENEZES",
        "first_name": "JONATHAN",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "8043674471",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0077856",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "DC",
            "license": "MD041163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewa",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1890 Metro Center Dr",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201905286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Mejia Sanchez
• Michael George Mellis, MD
• Rebecca Milloy Mello, LCSW
• Seth Nathaniel Meltzer, M.D.
• Bhavisha Menezes, M.D.
• John Alphonse Mercantini, DMD
• Pankaj Merchia, M.D.
• Messina Canal Moawad DDS PC
• Michael Messina
• Gamanya Metellus

• Geriatric Medicine (Family Medicine) Physician in Reston, VA
• Providers in Reston, VA by specialty
• Geriatric Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.