Active NPI
Miguel Ugalde
- Surgical Assistant
- Fairfax, VA
National Provider Identifier
1215329966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 12011 Lee Jackson Memorial Hwy Ste 501
Fairfax, VA 22033 - Phone
- (703) 259-7027
- NPI assigned
- Mar 3, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | Primary |
Addresses
Primary practice location
12011 Lee Jackson Memorial Hwy Ste 501
Fairfax, VA 22033
Mailing address
PO Box 221135
Chantilly, VA 20153-1135
Phone (703) 349-1379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfax Medical Associates,LLC | Surgical Assistant | Past | Accepting new patients |
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.
-
- Surgical Assistant
- Fairfax, VA
- NPI 1184147829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536192000000",
"number": "1215329966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 221135",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201531135",
"telephone_number": "703-349-1379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12011 LEE JACKSON MEMORIAL HWY STE 501",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "22033",
"telephone_number": "703-259-7027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UGALDE",
"first_name": "MIGUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-03",
"last_updated": "2018-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.