NPIMap

Organization Active NPI

Regenerative Orthopedics and Sports Medicine, LLC

  • Orthopaedic Surgery Physician
  • MC Lean, VA
National Provider Identifier
1275933533
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE, LLC
Practice address
1760 Old Meadow Rd Ste 220
MC Lean, VA 22102-4330
Phone
(703) 783-3529
Fax
(844) 681-7671
NPI assigned
Aug 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
David M Wang, MD
Title
Owner
Phone
(443) 222-0714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1760 Old Meadow Rd Ste 220
MC Lean, VA 22102-4330

Mailing address

1760 Old Meadow Rd Ste 220
MC Lean, VA 22102-4330
Phone (202) 681-7671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180104000398 DC Part B Supplier - Clinic/Group Practice 1355600941 Receives reassigned benefits from 14 practitioners
Practice locations: Falls Church, VA; MC Lean, VA; Reston, VA; Rockville, MD; Washington, DC; Fairfax, VA
O20181213000508 MD Part B Supplier - Clinic/Group Practice 1355600941 Receives reassigned benefits from 8 practitioners
Practice locations: Annapolis, MD; Columbia, MD; Easton, MD

National Provider Directory

National Provider Directory

Locations

19500 Sandridge Way
Ste 235
Leesburg, VA 20176
Phone (703) 829-9572

1760 Old Meadow Rd
Ste 210
McLean, VA 22102
Phone (703) 717-4264

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1408752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1275933533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 OLD MEADOW RD STE 220",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024330",
            "telephone_number": "202-681-7671",
            "fax_number": "844-681-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 OLD MEADOW RD STE 220",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024330",
            "telephone_number": "703-783-3529",
            "fax_number": "844-681-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-23",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-222-0714",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.