Individual provider Active NPI

Soma Tharakan, M.D.

  • Family Medicine Physician
  • Fairfax, VA
National Provider Identifier
1245427764
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101049206 Issued in VA
Practice address
10580 Arrowhead Drive
Fairfax Health Center
Fairfax, VA 22030
Phone
(571) 432-2680
Fax
(571) 432-2795
NPI assigned
Sep 28, 2007
Last updated
Mar 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101049206 VA Primary
Family Medicine Physician 207Q00000X MD20440 DC

Addresses

Primary practice location

10580 Arrowhead Drive
Fairfax Health Center
Fairfax, VA 22030

Mailing address

10580 Arrowhead Drive
Fairfax Health Center
Fairfax, VA 22030
Phone (571) 432-2680

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
I20170202002102 VA Order and Referring Only - Family PracticePractitioner - Family Practice 7416138185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD20440DCMDFamily Medicine Physician
0101049206VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1245427764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10580 ARROWHEAD DRIVE",
            "address_2": "FAIRFAX HEALTH CENTER",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "571-432-2680",
            "fax_number": "571-432-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10580 ARROWHEAD DRIVE",
            "address_2": "FAIRFAX HEALTH CENTER",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "571-432-2680",
            "fax_number": "571-432-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARAKAN",
        "first_name": "SOMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101049206",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD20440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.