Individual provider Active NPI

Seema S Nair, M.D.

  • Family Medicine Physician
  • Fairfax, VA
National Provider Identifier
1255479796
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60429431 Issued in WA
Practice address
4375 Fair Lakes CT
Fairfax, VA 22033-4234
Phone
(571) 432-2786
Fax
(571) 432-2796
NPI assigned
Feb 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60429431 WA Primary

Addresses

Primary practice location

4375 Fair Lakes CT
Fairfax, VA 22033-4234

Mailing address

4375 Fair Lakes CT
Fairfax, VA 22033-4234
Phone (571) 432-2600

Other identifiers 2

IdentifierTypeStateIssuer
2036396MedicaidWA
1255479796MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20140710002011 WA Practitioner - Family Practice 4789723693 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Family Medicine CurrentSince Jun 16, 2014 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Jun 16, 2014 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
The Polyclinic PLLC Family Medicine Current Accepting new patients
Dr Arun K Gupta PC PastSince Jul 21, 2024 Accepting new patients
Peninsula Cancer Center LLC PastSince May 16, 2021 Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

4410 106th St SW
Mukilteo, WA 98275
Phone (206) 388-6000

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

1145 Broadway
Fl 2
Seattle, WA 98122
Phone (206) 860-3509

1145 Broadway
Seattle, WA 98122

Interoperability endpoints

  • Direct secure messaging: snair119574@direct.rivhs.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1255479796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 FAIR LAKES CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334234",
            "telephone_number": "571-432-2600",
            "fax_number": "571-432-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 FAIR LAKES CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334234",
            "telephone_number": "571-432-2786",
            "fax_number": "571-432-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR",
        "first_name": "SEEMA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-04",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60429431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2036396",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255479796",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.