Madhubala A Kothari, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101263835 Issued in VA

Practice address

1860 Town Center Dr
Ste 210
Reston, VA 20190-5905

Phone

(330) 455-0374

Fax

(330) 455-2101

NPI assigned

May 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, DC2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of Ohio Office of Budget and Management State Accounting

  • Psychiatric Hospital
  • Cincinnati, OH
  • NPI 1023082716
  Medicare reassignment NPD
• Chattree and Associates LTD

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beachwood, OH
  • NPI 1962448654
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1245287515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR",
            "address_2": "STE 210",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905905",
            "telephone_number": "330-455-0374",
            "fax_number": "330-455-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR",
            "address_2": "STE 210",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905905",
            "telephone_number": "330-455-0374",
            "fax_number": "330-455-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHARI",
        "first_name": "MADHUBALA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101263835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7610021",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julija Kondratyuk, D.M.D
• Peter Reid Kongstvedt, M.D.
• Marisa Konishi, FNP
• Agnes Emma Koroma
• Mary Jane Catherine Korrigan, RDH
• Nancy Paula Krall, D.P.T.
• Anna Agnieszka Kraszewska, MD
• Alexander Krause
• Alexandra Krens, LPC-R
• Carmen Kresha, RD

• Psychiatry Physician in Reston, VA
• Providers in Reston, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.