Individual provider Active NPI

Theodore Marcus Friedman, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fairfax, VA
National Provider Identifier
1164608451
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0101249423 Issued in VA
Practice address
3600 Joseph Siewick Dr
Dept of Pathology, Inova Fair Oaks Hospital
Fairfax, VA 22033-1709
Phone
(703) 391-3654
NPI assigned
Jan 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101249423 VA Primary

Addresses

Primary practice location

3600 Joseph Siewick Dr
Dept of Pathology, Inova Fair Oaks Hospital
Fairfax, VA 22033-1709

Mailing address

3600 Joseph Siewick Dr
Dept of Pathology, Inova Fair Oaks Hospital
Fairfax, VA 22033-1709
Phone (703) 391-3654

Other identifiers 1

IdentifierTypeStateIssuer
169935001MedicaidAR

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
I20120307000593 DC Practitioner - Pathology 8022183706 Reassigns benefits to 2 organizations
I20140507002208 VA Practitioner - Pathology 8022183706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Geisel School of Medicine at Dartmouth, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care Services - PathologyGroup PAC ID 8426241647, 46 clinicians

Practice addresses (Care Compare)

3023 Hamaker CT
Suite 400
Fairfax, VA 22031-2247
Phone (571) 226-8380

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.94 of 100Reported as individual
Quality
91.31
Improvement activities
0
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101249423VAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services - Pathology Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2014 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2015 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2015 Accepting new patients

Locations

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

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.

Hospital & facility affiliations 4

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": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1164608451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 JOSEPH SIEWICK DR",
            "address_2": "DEPT OF PATHOLOGY, INOVA FAIR OAKS HOSPITAL",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331709",
            "telephone_number": "703-391-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 JOSEPH SIEWICK DR",
            "address_2": "DEPT OF PATHOLOGY, INOVA FAIR OAKS HOSPITAL",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331709",
            "telephone_number": "703-391-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "THEODORE",
        "middle_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-16",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101249423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169935001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.