Individual provider Active NPI

Mandeep Sandhu, MD

  • Internal Medicine Physician
  • Lansdowne, VA
National Provider Identifier
1205836798
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101221173 Issued in VA
Practice address
19415 Deerfield Ave
Suite 115
Lansdowne, VA 20176-8452
Phone
(703) 729-2626
Fax
(703) 729-3141
NPI assigned
Jul 26, 2005
Last updated
Feb 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101221173 VA Primary

Addresses

Primary practice location

19415 Deerfield Ave
Suite 115
Lansdowne, VA 20176-8452

Mailing address

19415 Deerfield Ave
Suite 115
Lansdowne, VA 20176-8452
Phone (703) 729-2626

Other identifiers 3

IdentifierTypeStateIssuer
236002OtherVAANTHEM
P00311835OtherMEDICARE RAILROAD
5865557MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000522 VA Practitioner - Internal Medicine 5395931877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loudoun Medical Care PCGroup PAC ID 1254365414, 2 clinicians

Practice addresses (Care Compare)

19415 Deerfield Ave
Lansdowne, VA 20176-8470
Phone (703) 729-2626

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101221173VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Care PC Internal Medicine CurrentSince Jun 6, 2001 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Physicians Practice and Research, LLC Past Accepting new patients

Locations

19415 Deerfield Ave
Ste 115
Leesburg, VA 20176
Phone (703) 729-2626

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJDIDD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1205836798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE",
            "address_2": "SUITE 115",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201768452",
            "telephone_number": "703-729-2626",
            "fax_number": "703-729-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE",
            "address_2": "SUITE 115",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201768452",
            "telephone_number": "703-729-2626",
            "fax_number": "703-729-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "MANDEEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101221173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "236002",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00311835",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5865557",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdowne, VA

Sources for this page

Verify at the official NPI Registry.