Pediatric Practice,PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101222057 Issued in VA

Legal business name

PEDIATRIC PRACTICE,PC

Practice address

8600 Rolling Rd Ste 100
Manassas, VA 20110-3868

Phone

(703) 361-3870

Fax

(703) 361-3871

NPI assigned

Jul 6, 2007

Reactivated

Apr 19, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Sanjay Lamba, MDNPI 1124069901

Title

President

Phone

(703) 361-3870

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7645/brand/1/csg/1/fhir/r4

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sanjay Lamba, MD

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1124069901
  NPD (past) Authorized official
• Moona Hamad

  • Nurse Practitioner
  • Alexandria, VA
  • NPI 1962358440
  NPD (past)
• Renee Malove, FNP-C

  • Family Nurse Practitioner
  • Fredericksburg, VA
  • NPI 1275330714
  NPD (past)
• Rebecca Sue Patel, NP-BC

  • Family Nurse Practitioner
  • Alexandria, VA
  • NPI 1568711810
  NPD (past)

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1205034659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5131 PLEASANT FOREST DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201249",
            "telephone_number": "703-803-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 ROLLING RD STE 100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103868",
            "telephone_number": "703-361-3870",
            "fax_number": "703-361-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PRACTICE,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2024-04-19",
        "certification_date": "2020-02-27",
        "deactivation_date": "2020-02-27",
        "reactivation_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "LAMBA",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-361-3870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101222057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006702015",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea T Peda, DVM
• Judith C Pederson, MD
• Pediatric Associates of Manassas
• Pediatric Associates of Northern Virginia, P.C. (Olde Towne Pediatrics)
• Pediatric Associates of Prince William County, LLC
• Pediatricare of Northern Virginia, P.C.
• Pediatrix Medical Group PC
• Kevin Edward Peltier I, MD
• Nicole Penke, MD
• Anna Penna, MD

• Pediatrics Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.