Prem Manchanda, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101057630 Issued in VA

Practice address

4100 Orchard Dr
Fairfax, VA 22032-1021

Phone

(703) 981-4865

Fax

(804) 414-7762

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

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.

• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment NPD
• Inova Physician Partners, LLC

  • Family Medicine Physician
  • Chantilly, VA
  • NPI 1215264916

  DC

  Medicare reassignment NPD
• Inova Health Care Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD
• Inova Physician Partners, Inc. - Specialists

  • Orthopaedic Surgery Physician
  • Leesburg, VA
  • NPI 1811204050
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1063578060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUIYE 220",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-910-3484",
            "fax_number": "804-414-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 ORCHARD DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220321021",
            "telephone_number": "703-981-4865",
            "fax_number": "804-414-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHANDA",
        "first_name": "PREM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D54095",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101057630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmanchanda25686@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Exchange Information",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3833 Fairfax Dr Ste 200",
            "city": "Arlington",
            "state": "VA",
            "country_code": "US",
            "postal_code": "222031773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karin Annette Maloney, MS, CF-SLP
• Shannon Nicole Maloney
• Suzanne Messer Malouf, CRNP
• Ronald James Malsam, RPH
• Janice Manase
• Sumerta Manchandani, M.D
• Paulina J Mancoske, DNP, FNP-BC, NP-C
• Kristen Ann Mancuso, RN
• Mary Florence Mandell, LICSW
• Suneetha Manem, M.D.

• Internal Medicine Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.

Verify at the official NPI Registry.