Individual provider Active NPI

Rachana Potru, M.D.

  • Gastroenterology Physician
  • Annandale, VA
National Provider Identifier
1235395583
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101253503 Issued in VA
Practice address
3299 Woodburn Rd Ste 220
Annandale, VA 22003-7318
Phone
(703) 522-7476
Fax
(703) 204-1968
NPI assigned
Aug 5, 2008
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AP3881528-72219 IL
Gastroenterology Physician 207RG0100X 0101253503 VA Primary

Addresses

Primary practice location

3299 Woodburn Rd Ste 220
Annandale, VA 22003-7318

Mailing address

3299 Woodburn Rd Ste 220
Annandale, VA 22003-7318
Phone (703) 522-7476

Other practice location 1

47 New Scotland Ave
Gastroenterology Department
Albany, NY 12208-3412
Phone (518) 262-6858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20130730000221 DC Practitioner - Gastroenterology 5193966497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Rush Medical College of Rush University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastroenterology Center of Northern Virginia LTDGroup PAC ID 0042256406, 5 clinicians

Practice addresses (Care Compare)

1715 N George Mason Dr
Suite 204
Arlington, VA 22205-3647
Phone (703) 522-7476

3299 Woodburn Rd
Suite 220
Annandale, VA 22003-7318
Phone (703) 560-6106

3301 Woodburn Rd
Suite 220
Annandale, VA 22003-7318

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy79
Upper gastrointestinal (GI) endoscopy for acid reflux45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP3881528-72219ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Center of Northern Virginia LTD Gastroenterology CurrentSince Aug 1, 2013 Accepting new patients

Locations

3299 Woodburn Rd
Ste 220
Annandale, VA 22003
Phone (220) 270-3747

1715 N George Mason Dr
Ste 204
Arlington, VA 22205
Phone (703) 522-7476

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, 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": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1235395583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3299 WOODBURN RD STE 220",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220037318",
            "telephone_number": "703-522-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3299 WOODBURN RD STE 220",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220037318",
            "telephone_number": "703-522-7476",
            "fax_number": "703-204-1968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Ave",
            "address_2": "Gastroenterology Department",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-6858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTRU",
        "first_name": "RACHANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "AP3881528-72219",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101253503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.