Active NPI
Samina S. Raja, MD
- Psychiatry Physician
- Fairfax, VA
National Provider Identifier
1023336575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2014-01263
- Practice address
- 3993 Alcoa Dr
Fairfax, VA 22033-1402 - Phone
- (703) 579-7667
- NPI assigned
- May 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 2014-01263 | NC | Primary |
Addresses
Primary practice location
3993 Alcoa Dr
Fairfax, VA 22033-1402
Mailing address
3993 Alcoa Dr
Fairfax, VA 22033-1402
Phone (703) 579-7667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014-01263 | NC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuropsych Wellness Center, PC | Psychiatry | Current | Accepting new patients |
Locations
3930 Pender Dr
Ste 240
Fairfax, VA 22030
Phone (703) 865-8686
3930 Pender Dr
Ste 350
Fairfax, VA 22030
Phone (703) 865-6565
Organizations & group practices 1
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": "1273190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440460800000",
"number": "1023336575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3993 ALCOA DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220331402",
"telephone_number": "703-579-7667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3993 ALCOA DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220331402",
"telephone_number": "703-579-7667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJA",
"first_name": "SAMINA",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-07",
"last_updated": "2015-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "2014-01263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.