Individual provider Active NPI

Sini Eapen, NURSE PRACTITIONER

  • Nurse Practitioner
  • Manassas, VA
National Provider Identifier
1184246787
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024178582 Issued in VA
Practice address
9380 Forestwood Lane
9380 Unit B
Manassas, VA 20110
Phone
(703) 335-2779
NPI assigned
May 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024178582 VA Primary

Addresses

Primary practice location

9380 Forestwood Lane
9380 Unit B
Manassas, VA 20110

Mailing address

9380 Forestwood Lane
9380 Unit B
Manassas, VA 20110
Phone (703) 335-2779

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
I20200922003311 VA Practitioner - Nurse Practitioner 9537588629 Reassigns benefits to 2 organizations
I20201209002912 DC Practitioner - Nurse Practitioner 9537588629 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024178582VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Hospital Inc. CurrentSince Sep 1, 2020 Accepting new patients
Psychogeriatric Services LLC Nurse Practitioner CurrentSince Dec 2, 2020 Accepting new patients
Catholic Charaties Diocese of Arlington CurrentSince Jun 30, 2024 Accepting new patients
Mary Washington Hospital, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Northspring Behavioral Healthcare Inc Past Accepting new patients

Locations

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

1200 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 372-3900

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

9380 Forestwood Ln
Ste B
Manassas, VA 20110
Phone (703) 335-2779

8575 Rixlew Ln
Manassas, VA 20109
Phone (703) 257-9770

Organizations & group practices 5

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": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1184246787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9380 FORESTWOOD LANE",
            "address_2": "9380 UNIT B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20110",
            "telephone_number": "703-335-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9380 FORESTWOOD LANE",
            "address_2": "9380 UNIT B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20110",
            "telephone_number": "703-335-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAPEN",
        "first_name": "SINI",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024178582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.