Individual provider Active NPI

Carolyn Ming-Wai Kwok Sanchez, M.D.

  • Pediatrics Physician
  • Ashburn, VA
National Provider Identifier
1316152200
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101265805 Issued in VA
Practice address
43480 Yukon Dr Ste 2200
Ashburn, VA 20147-6988
Phone
(703) 359-7878
NPI assigned
May 13, 2007
Last updated
May 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 8734530-1205 UT
Pediatrics Physician 208000000X 0101265805 VA Primary

Addresses

Primary practice location

43480 Yukon Dr Ste 2200
Ashburn, VA 20147-6988

Mailing address

42813 Vestals Gap Dr
Broadlands, VA 20148-4041
Phone (914) 419-4544

Other practice location 1

42813 Vestals Gap Dr
Broadlands, VA 20148-4041
Phone (914) 419-4544

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, VA2 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
I20131111001118 UT Practitioner - Pediatric Medicine 4880867837 Reassigns benefits to 1 organization
I20191002002101 VA Practitioner - Pediatric Medicine 4880867837 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8734530-1205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Community Physicians Group Current Accepting new patients
University of Utah Community Physicians Group CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Community Physicians Group CurrentSince Feb 1, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 12, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 12, 2019 Accepting new patients

Locations

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

7495 S State St
Midvale, UT 84047
Phone (801) 213-9400

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

43480 Yukon Dr
Ste 100
Ashburn, VA 20147
Phone (571) 252-6000

43480 Yukon Dr
Ste 2200
Ashburn, VA 20147

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1316152200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42813 VESTALS GAP DR",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201484041",
            "telephone_number": "914-419-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43480 YUKON DR STE 2200",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476988",
            "telephone_number": "703-359-7878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42813 Vestals Gap Dr",
            "address_purpose": "LOCATION",
            "city": "Broadlands",
            "state": "VA",
            "postal_code": "201484041",
            "country_code": "US",
            "telephone_number": "914-419-4544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "CAROLYN",
        "middle_name": "MING-WAI KWOK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-13",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "8734530-1205",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101265805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43480 Yukon Dr Ste 2200",
            "city": "Ashburn",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201476988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.