Individual provider Active NPI

Augustine A Dolcich, MD

  • Family Medicine Physician
  • Chantilly, VA
National Provider Identifier
1346234648
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101051034 Issued in VA
Practice address
4080 Lafayette Center Drive
Ste 170
Chantilly, VA 20151
Phone
(703) 766-5040
Fax
(703) 766-5047
NPI assigned
Sep 1, 2005
Last updated
May 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 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 0101051034 VA Primary

Addresses

Primary practice location

4080 Lafayette Center Drive
Ste 170
Chantilly, VA 20151

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other identifiers 2

IdentifierTypeStateIssuer
05624266MedicaidVA
080177774OtherRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adolcich708904@soc.inova.org Health Information Exchange (HIE) Inova Physician Partners, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20110318000264 DC Practitioner - Family Practice 8527241298 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairfax Family Practice Centers PCGroup PAC ID 4082513031, 106 clinicians

Practice addresses (Care Compare)

11800 Sunrise Valley Dr
Suite 700
Reston, VA 20191-5315
Phone (703) 834-1473

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Family Medicine CurrentSince Jun 15, 2015 Accepting new patients
Inova Physician Partners, LLC Family Medicine CurrentSince Jun 25, 2020 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 15, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

6201 Centreville Rd
Ste 100
Centreville, VA 20121
Phone (703) 263-9600

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

4080 Lafayette Center Dr
Ste 170
Chantilly, VA 20151
Phone (703) 327-9773

3650 Joseph Siewick Dr
Ste 400
Fairfax, VA 22033
Phone (703) 391-2020

11800 Sunrise Valley Dr
Ste 700
Reston, VA 20191
Phone (703) 834-1473

1850 Town Center Pkwy
Ste 412
Reston, VA 20190
Phone (703) 478-9390

115 Park St SE
Ste 300
Vienna, VA 22180
Phone (703) 255-9100

Interoperability endpoints

  • Direct secure messaging: adolcich708904@soc.inova.org

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.

Hospital & facility affiliations 5

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1346234648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "703-766-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 LAFAYETTE CENTER DRIVE",
            "address_2": "STE 170",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "20151",
            "telephone_number": "703-766-5040",
            "fax_number": "703-766-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLCICH",
        "first_name": "AUGUSTINE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101051034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05624266",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080177774",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adolcich708904@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "11800 Sunrise Valley Dr Ste 700",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201915315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

Verify at the official NPI Registry.