Individual provider Active NPI

Anil Mathew Chenthitta, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Leesburg, VA
National Provider Identifier
1275769168
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
0101252929 Issued in VA
Practice address
19450 Deerfield Ave Ste 280
Leesburg, VA 20176-6821
Phone
(571) 510-3815
Fax
(571) 510-3675
NPI assigned
Jun 5, 2009
Last updated
Mar 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X ME128763 FL
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X 0101252929 VA Primary

Addresses

Primary practice location

19450 Deerfield Ave Ste 280
Leesburg, VA 20176-6821

Mailing address

19450 Deerfield Ave Ste 280
Leesburg, VA 20176-6821
Phone (571) 510-3815

Other identifiers 3

IdentifierTypeStateIssuer
0101252929OtherVALICENSE NO
1275769168MedicaidVA
P01159671OtherVARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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

Enrollment IDStateProvider typePAC IDDetails
I20130228000142 DC Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 4688829476 Reassigns benefits to 1 organization
I20130529000473 VA Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 4688829476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
University of Texas Southwestern Medical School at Dallas, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19450 Deerfield Ave
Suite 280
Leesburg, VA 20176-6821
Phone (571) 510-3815

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101252929VAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Interoperability endpoints

  • Direct secure messaging: anil.chenthitta@direct.einstein.edu
  • FHIR API: https://fhir4.healow.com/fhir/r4/GDBHCD/Endpoint/GDBHCD

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": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1275769168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVE STE 280",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766821",
            "telephone_number": "571-510-3815",
            "fax_number": "571-510-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVE STE 280",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766821",
            "telephone_number": "571-510-3815",
            "fax_number": "571-510-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENTHITTA",
        "first_name": "ANIL",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME128763",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101252929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO",
            "identifier": "0101252929",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275769168",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01159671",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.