Individual provider Active NPI

Sandeep Kaur, PA

  • Medical Physician Assistant
  • Fairfax, VA
National Provider Identifier
1093590168
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110009500 Issued in VA
Practice address
9404A Main St
Fairfax, VA 22031-4032
Phone
(571) 404-6974
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110009500 VA Primary

Addresses

Primary practice location

9404A Main St
Fairfax, VA 22031-4032

Mailing address

9404-A Main Street
Fairfax, VA 22031

Other identifiers 2

IdentifierTypeStateIssuer
30017688630001MedicaidVA
0110009500MedicaidVA

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231004000280 VA Practitioner - Physician Assistant 3577917939 Reassigns benefits to 2 organizations
I20240807000881 DC Practitioner - Physician Assistant 3577917939 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
San Juan Bautista School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Ucc LLCGroup PAC ID 7012385040, 158 clinicians
Baby Doc IncGroup PAC ID 7719397587, 10 clinicians

Practice addresses (Care Compare)

11670 Sudley Manor Dr
Manassas, VA 20109-2842
Phone (571) 569-3526

1488 Northpoint VLG Ctr
Inova Ghlth Ucc Rest
Reston, VA 20194-1190
Phone (571) 525-5850

180 Maple Ave W
Vienna, VA 22180-5727
Phone (703) 938-5300

2118 S Pleasant Valley Rd
Suite 38
Winchester, VA 22601-7003
Phone (540) 545-9999

2415 Centreville Rd
Suite B6
Herndon, VA 20171-3029
Phone (571) 376-4000

24801 Pinebrook Rd
Suite 110
Chantilly, VA 20152-4113
Phone (703) 722-2500

42010 Village Ctr PLZ
Suite 100
Aldie, VA 20105-3036

43135 Broadlands Ctr PLZ
Suite 123
Broadlands, VA 20148-3804
Phone (571) 206-0742

6201 Centreville Rd
Suite 200
Centreville, VA 20121-2626
Phone (571) 549-8577

6206 Rolling Rd
Springfield, VA 22152-2306
Phone (571) 889-3235

9404 A Main St
Fairfax, VA 22031-4032
Phone 47027679312302

9427 Lorton Market St
Lorton, VA 22079-1963
Phone (571) 336-7614

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.6 of 100Reported as group
Quality
84.42
Promoting interoperability
100
Improvement activities
40
Cost
77.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: skaur1440586@soc.inova.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1093590168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9404-A MAIN STREET",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9404A MAIN ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314032",
            "telephone_number": "571-404-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "SANDEEP",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110009500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017688630001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110009500",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.