Individual provider Active NPI

Mariana Julia Niemtzoff, MD

  • Psychiatry Physician
  • Arlington, VA
National Provider Identifier
1285608190
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101224428 Issued in VA
Practice address
1001 N Vermont St
Suite 102
Arlington, VA 22201-4763
Phone
(703) 527-3766
Fax
(888) 392-5707
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101224428 VA Primary

Addresses

Primary practice location

1001 N Vermont St
Suite 102
Arlington, VA 22201-4763

Mailing address

1001 N Vermont St
Suite 102
Arlington, VA 22201-4763
Phone (703) 527-3766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2016 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101224428VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whitman-Walker Clinic Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1285608190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N VERMONT ST",
            "address_2": "SUITE 102",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222014763",
            "telephone_number": "703-527-3766",
            "fax_number": "888-392-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N VERMONT ST",
            "address_2": "SUITE 102",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222014763",
            "telephone_number": "703-527-3766",
            "fax_number": "888-392-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMTZOFF",
        "first_name": "MARIANA",
        "middle_name": "JULIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101224428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.