NPIMap

Organization Active NPI

My Psychiatrist LLC

Doing business as My Psychiatrist PLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Reston, VA
National Provider Identifier
1295048684
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MY PSYCHIATRIST LLC
Doing business as
My Psychiatrist PLC
Practice address
12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463
Phone
(703) 596-4796
NPI assigned
Jul 14, 2010
Last updated
Dec 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Madan UpretyNPI 1528109758
Title
Ceo
Phone
(703) 596-4796

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463

Mailing address

12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463
Phone (703) 596-4796

Other practice location 1

6565 Arlington Blvd Ste 405
Falls Church, VA 22042-3000
Phone (703) 596-4796

Other names 1

  • My Psychiatrist PLC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100805000650 DC Part B Supplier - Clinic/Group Practice 5597898981 Receives reassigned benefits from 21 practitioners
Practice locations: Reston, VA; Falls Church, VA
O20140616000128 VA Part B Supplier - Clinic/Group Practice 5597898981 Receives reassigned benefits from 4 practitioners
Practice locations: Gainesville, VA; Manassas, VA

National Provider Directory

National Provider Directory

Locations

6565 Arlington Blvd
Ste 405
Falls Church, VA 22042
Phone (571) 946-2189

7001 Heritage Village Plz
Ste 240
Gainesville, VA 20155
Phone (571) 248-9933

12359 Sunrise Valley Dr
#32
Reston, VA 20191
Phone (703) 596-4796

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1295048684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "703-596-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "703-596-4796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 Arlington Blvd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423000",
            "country_code": "US",
            "telephone_number": "703-596-4796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY PSYCHIATRIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-14",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "UPRETY",
        "authorized_official_first_name": "MADAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-596-4796"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Psychiatrist PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.