Active NPI
Soma Tharakan, M.D.
- Family Medicine Physician
- Fairfax, VA
National Provider Identifier
1245427764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101049206
- 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, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170202002102 | VA | Order and Referring Only - Family Practice | 7416138185 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD20440 | DC | MD | Family Medicine Physician |
| 0101049206 | VA | MD | Family 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.