Reconstructive Institute, LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

RECONSTRUCTIVE INSTITUTE, LLC

Practice address

2755 Hartland Rd Ste 300
Falls Church, VA 22043-3545

Phone

(703) 544-8971

NPI assigned

Jan 4, 2021

Organization subpart

No

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

Authorized official

Name

Daniel Glynn

Title

Billing

Phone

(703) 544-8971

Specialties & licenses 1

Addresses

Other names 1

• Reconstructive Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 2

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

• Marwan Riad Khalifeh, M.D.

  • Plastic Surgery Physician
  • MC Lean, VA
  • NPI 1871526426

  DC

  Medicare reassignment NPD
• Vineet Mehan, MD

  • Plastic Surgery Physician
  • Falls Church, VA
  • NPI 1194943555

  DC

  Medicare reassignment

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1215525571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 HARTLAND RD STE 300",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220433545",
            "telephone_number": "703-544-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 HARTLAND RD STE 300",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220433545",
            "telephone_number": "703-544-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECONSTRUCTIVE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "GLYNN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "703-544-8971"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reconstructive Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shinjni Razdan, DDS
• Brian Edward Razzino, PHD
• Reach Aut Therapeutics LLC
• Stephanie M Reagan
• Mary Beth Reckmeyer, NP
• Jonathan Clark Redding, BCBA
• Darsani Reddy, MD, MPH
• Gita Susan Reddy, M.D.
• Rediclinic of VA, LLC
• Kyle Patrick Reeb, D.C.

• Plastic and Reconstructive Surgery Physician in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Plastic and Reconstructive Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.