Individual provider Active NPI

Nihil C Theodore, M.D.

  • Family Medicine Physician
  • Manassas, VA
National Provider Identifier
1326049008
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101238129 Issued in VA
Practice address
8700 Sudley Rd
Manassas, VA 20110-4418
Phone
(703) 396-5292
Fax
(703) 396-5297
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101238129 VA Primary

Addresses

Primary practice location

8700 Sudley Rd
Manassas, VA 20110-4418

Mailing address

PO Box 748613
Atlanta, GA 30384-8613

Other identifiers 2

IdentifierTypeStateIssuer
10171679MedicaidVA
179071OtherVAANTHEM BC/BS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ntheodore306859@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050928000589 VA Practitioner - HospitalistPractitioner - Family PracticePractitioner - Internal Medicine 7618902776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Tufts University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uva Community Health Medical Group LLCGroup PAC ID 4688587967, 339 clinicians

Practice addresses (Care Compare)

8700 Sudley Rd
Manassas, VA 20110-4418
Phone (703) 396-5292

Hospital & facility affiliations

  • Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045
  • Uva Health Haymarket Medical Center Hospital, Haymarket, VA, CCN 490144
  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009
  • Uva Health Culpeper Medical Center Hospital, Culpeper, VA, CCN 490019
  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NMG Affiliate Practice I, LLC CurrentSince Jan 1, 2016 Accepting new patients
Uva Community Health Medical Group, LLC CurrentSince Jan 1, 2016 Accepting new patients

Locations

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

812 W Stuart Dr
Galax, VA 24333
Phone (276) 238-3318

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8691 Stonewall Rd
Manassas, VA 20110
Phone (703) 368-1182

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

Interoperability endpoints

  • Direct secure messaging: ntheodore306859@direct.novanthealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1326049008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748613",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 SUDLEY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104418",
            "telephone_number": "703-396-5292",
            "fax_number": "703-396-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "NIHIL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101238129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10171679",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "179071",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntheodore306859@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "8700 Sudley Rd",
            "city": "Manassas",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201104418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.