Organization Active NPI

Pulmonary Associates of Fredericksburg Inc

  • Pulmonary Disease Physician
  • Fredericksburg, VA
National Provider Identifier
1053340554
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY ASSOCIATES OF FREDERICKSBURG INC
Practice address
521 Park Hill Dr
Fredericksburg, VA 22401-3377
Phone
(540) 899-1615
Fax
(540) 372-3525
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Reina E Santos
Title
Billing Manager
Phone
(540) 899-1648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

521 Park Hill Dr
Fredericksburg, VA 22401-3377

Mailing address

521 Park Hill Dr
Fredericksburg, VA 22401-3377
Phone (540) 899-1615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304000828 VA Part B Supplier - Clinic/Group Practice 5799673596 Receives reassigned benefits from 13 practitioners
Practice locations: Fredericksburg, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2210896Pulmonary Associates of Fredericksburg521 Park Hill Dr, Fredericksburg, VA 22401Certificate of waiverJan 24, 2027

National Provider Directory

National Provider Directory

Locations

1101 Sam Perry Blvd
Ste 411
Fredericksburg, VA 22401
Phone (540) 741-7846

521 Park Hill Dr
Fredericksburg, VA 22401
Phone (540) 899-1615

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1053340554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 PARK HILL DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013377",
            "telephone_number": "540-899-1615",
            "fax_number": "540-372-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 PARK HILL DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013377",
            "telephone_number": "540-899-1615",
            "fax_number": "540-372-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY ASSOCIATES OF FREDERICKSBURG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "REINA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "540-899-1648"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.