NPIMap

Organization Active NPI

Surgical Consultants of Northern Virginia PLLC

  • Surgery Physician
  • Vienna, VA
National Provider Identifier
1275938136
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101246899 Issued in VA
Legal business name
SURGICAL CONSULTANTS OF NORTHERN VIRGINIA PLLC
Practice address
1655 Hunting Crest Way
Vienna, VA 22182-1563
Phone
(703) 678-7980
NPI assigned
Nov 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
Brett Sachse, M.D.NPI 1518975317
Title
Owner
Phone
(703) 678-7980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 0101246899 VA Primary

Addresses

Primary practice location

1655 Hunting Crest Way
Vienna, VA 22182-1563

Mailing address

1655 Hunting Crest Way
Vienna, VA 22182-1563

Other identifiers 1

IdentifierTypeStateIssuer
1518975317OtherINDIVIDUAL NPI NUMBER

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150309000583 DC Part B Supplier - Clinic/Group Practice 1658697735 Receives reassigned benefits from 5 practitioners
Practice locations: Reston, VA
O20210506001800 VA Part B Supplier - Clinic/Group Practice 1658697735 Receives reassigned benefits from 4 practitioners
Practice locations: Dulles, VA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22827/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1275938136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 HUNTING CREST WAY",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221821563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 HUNTING CREST WAY",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221821563",
            "telephone_number": "703-678-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL CONSULTANTS OF NORTHERN VIRGINIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "SACHSE",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-678-7980",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101246899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1518975317",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.