Individual provider Active NPI

Laurence S Shindelman

  • Psychiatry Physician
  • Woodbridge, VA
National Provider Identifier
1073634960
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
100835 Issued in NY
Practice address
15941 Donald Curtis Dr
Woodbridge, VA 22191
Phone
(703) 792-7800
Fax
(703) 792-5699
NPI assigned
Apr 2, 2007
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 100835 NY Primary

Addresses

Primary practice location

15941 Donald Curtis Dr
Woodbridge, VA 22191

Mailing address

1350 Beverly Rd Apt 1224
MC Lean, VA 22101-3934
Phone (703) 663-8578

Other identifiers 1

IdentifierTypeStateIssuer
100835MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20180815000477 VA Practitioner - Psychiatry 3375892961 Reassigns benefits to 1 organization
I20210203002864 DC Practitioner - Psychiatry 3375892961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2100 Washington Blvd
Arlington, VA 22204-5717
Phone (703) 228-1611

2100 Washington Blvd
Suite 400
Arlington, VA 22204-5703

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100835NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County Community Services Board CurrentSince Jun 18, 2018 Accepting new patients
Prince William County CurrentSince Jun 18, 2018 Accepting new patients

Locations

7969 Ashton Ave
Manassas, VA 20109
Phone (703) 792-7826

14011 Worth Ave
Ste 110
Woodbridge, VA 22192

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1073634960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BEVERLY RD APT 1224",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013934",
            "telephone_number": "703-663-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15941 DONALD CURTIS DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22191",
            "telephone_number": "703-792-7800",
            "fax_number": "703-792-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINDELMAN",
        "first_name": "LAURENCE",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "100835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100835",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.