Individual provider Active NPI

Katherine W Khalifeh, MD

  • Colon & Rectal Surgery Physician
  • Fairfax, VA
National Provider Identifier
1043356843
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
0101252601 Issued in VA
Practice address
2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357
Phone
(703) 280-2841
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101252601 VA
Urology Physician 208800000X 000000 MD
Colon & Rectal Surgery Physician 208C00000X 0101252601 VA Primary

Addresses

Primary practice location

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357

Mailing address

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357
Phone (703) 280-2841

Other practice location 1

8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone (571) 472-4724

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkhalifeh54565@soc.inova.org Health Information Exchange (HIE) Inova Health Care Services

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121102000368 DC Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 8022269828 Reassigns benefits to 3 organizations
I20151209000009 VA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 8022269828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Johns Hopkins University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairfax Colon and Rectal Surgery PCGroup PAC ID 4385628411, 12 clinicians
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4358
Phone (703) 280-2841

44045 Riverside Pkwy
Suite 102
Lansdowne, VA 20176-5101
Phone (703) 280-2841

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy41
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000000MDMDGeneral Practice Dentistry
0101252601VAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Feb 4, 2021 Accepting new patients
Inova Health Care Services Current Accepting new patients
Fairfax Colon & Rectal Surgery, PC Colon & Rectal Surgery CurrentSince Nov 1, 2012 Accepting new patients
Fairfax Colon & Rectal Surgery Center, LLC Colon & Rectal Surgery Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2710 Prosperity Ave
Fairfax, VA 22031
Phone (702) 289-1290

2710 Prosperity Ave
Ste 200
Fairfax, VA 22031
Phone (703) 650-2333

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

7051 Heathcote Village Way
Ste 135
Gainesville, VA 20155

44045 Riverside Pkwy
Ste 102
Lansdowne, VA 20176

44055 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 724-7530

44055 Riverside Pkwy
Ste 102
Leesburg, VA 20176
Phone (703) 858-1500

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAEJBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/EAEJBD/Endpoint/EAEJBD
  • Direct secure messaging: katherine.khalifeh@fcrs.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1043356843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 PROSPERITY AVE",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314357",
            "telephone_number": "703-280-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 PROSPERITY AVE",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314357",
            "telephone_number": "703-280-2841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8081 Innovation Park Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314867",
            "country_code": "US",
            "telephone_number": "571-472-4724",
            "fax_number": "571-472-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALIFEH",
        "first_name": "KATHERINE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101252601",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MD",
            "license": "000000",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "VA",
            "license": "0101252601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkhalifeh54565@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8081 Innovation Park Dr",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.