Individual provider Active NPI

John B Cleary, M.D.

  • Pulmonary Disease Physician
  • Fairfax, VA
National Provider Identifier
1285636514
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0101026305 Issued in VA
Practice address
3650 Joseph Siewick Dr
Ste 307
Fairfax, VA 22033-1715
Phone
(703) 391-8804
Fax
(703) 391-5659
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101026305 VA
Pulmonary Disease Physician 207RP1001X 0101026305 VA Primary

Addresses

Primary practice location

3650 Joseph Siewick Dr
Ste 307
Fairfax, VA 22033-1715

Mailing address

3650 Joseph Siewick Dr
Ste 307
Fairfax, VA 22033-1715
Phone (703) 391-8804

Other identifiers 1

IdentifierTypeStateIssuer
6077277MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20100416000759 VA Practitioner - Pulmonary Disease 9436118650 Reassigns benefits to 2 organizations
I20110223000768 DC Practitioner - Pulmonary Disease 9436118650 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101026305VAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Inova Health Care Services Critical Care Medicine CurrentSince Mar 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3650 Joseph Siewick Dr
Ste 110
Fairfax, VA 22033
Phone (703) 391-8804

3650 Joseph Siewick Dr
Ste 307
Fairfax, VA 22033
Phone (703) 391-2543

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

8650 Sudley Rd
Ste 212
Manassas, VA 20110
Phone (703) 369-0600

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

Interoperability endpoints

  • Direct secure messaging: john.cleary@pccsnova.directbygreenway.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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1285636514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR",
            "address_2": "STE 307",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331715",
            "telephone_number": "703-391-8804",
            "fax_number": "703-391-5659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR",
            "address_2": "STE 307",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331715",
            "telephone_number": "703-391-8804",
            "fax_number": "703-391-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101026305",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101026305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6077277",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.