Active NPI
Dulles Medical Group LLC
- Geriatric Medicine (Internal Medicine) Physician
- Leesburg, VA
National Provider Identifier
1053408732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 0101045895
- Legal business name
- DULLES MEDICAL GROUP LLC
- Practice address
- 224D Cornwall St NW
Suite 303
Leesburg, VA 20176-2700 - Phone
- (703) 777-8840
- Fax
- (703) 779-0887
- NPI assigned
- Oct 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Anil J Patel, M.D.
- Title
- President
- Phone
- (703) 777-8840
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 0101045895 | VA | Primary |
Addresses
Primary practice location
224D Cornwall St NW
Suite 303
Leesburg, VA 20176-2700
Mailing address
224D Cornwall St NW
Suite 303
Leesburg, VA 20176-2700
Phone (703) 777-8840
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A840-001 | Other | VA | CAREFIRST |
| 070317 | Other | VA | BLUECROSS BLUESHIELD |
| 005842875 | Medicaid | VA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1231977600000",
"number": "1053408732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224D CORNWALL ST NW",
"address_2": "SUITE 303",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201762700",
"telephone_number": "703-777-8840",
"fax_number": "703-779-0887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224D CORNWALL ST NW",
"address_2": "SUITE 303",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201762700",
"telephone_number": "703-777-8840",
"fax_number": "703-779-0887"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DULLES MEDICAL GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-06",
"last_updated": "2009-01-15",
"status": "A",
"authorized_official_last_name": "PATEL",
"authorized_official_first_name": "ANIL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "703-777-8840",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "VA",
"license": "0101045895",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "A840-001",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "070317",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005842875",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.