Individual provider Active NPI

Dipti Amit Surve, MBBS

  • Anatomic Pathology & Clinical Pathology Physician
  • Reston, VA
National Provider Identifier
1154555183
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0101253532 Issued in VA
Practice address
1850 Town Center Pkwy
Reston, VA 20190-3204
Phone
(703) 689-9093
Fax
(703) 639-9580
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X VA
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101253532 VA Primary

Addresses

Primary practice location

1850 Town Center Pkwy
Reston, VA 20190-3204

Mailing address

PO Box 745344
Atlanta, GA 30374-5344
Phone (703) 689-9093

Other practice location 1

4820 Garden Spring Ln
Apt#306
Glen Allen, VA 23059-7546
Phone (408) 718-0235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20200325002913 DC Practitioner - Pathology 2466693122 Reassigns benefits to 1 organization
I20210409001766 VA Practitioner - Pathology 2466693122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forward Pathology Solutions LLCGroup PAC ID 2668703109, 25 clinicians

Practice addresses (Care Compare)

1850 Town Ctr Pkwy
Reston, VA 20190-3204
Phone (703) 689-9093

Hospital & facility affiliations

  • Reston Hospital Center Hospital, Reston, VA, CCN 490107
  • Stonesprings Hospital Center Hospital, Dulles, VA, CCN 490145
  • Spotsylvania Regional Medical Center Hospital, Fredericksburg, VA, CCN 490141

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101253532VAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Pathology Solutions LLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2021 Accepting new patients

Locations

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

24440 Stone Springs Blvd
Sterling, VA 20166
Phone (571) 206-8696

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1154555183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745344",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303745344",
            "telephone_number": "703-689-9093",
            "fax_number": "703-639-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903204",
            "telephone_number": "703-689-9093",
            "fax_number": "703-639-9580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4820 Garden Spring Ln",
            "address_2": "Apt#306",
            "address_purpose": "LOCATION",
            "city": "Glen Allen",
            "state": "VA",
            "postal_code": "230597546",
            "country_code": "US",
            "telephone_number": "408-718-0235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURVE",
        "first_name": "DIPTI",
        "middle_name": "AMIT",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101253532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.