Individual provider Active NPI

Takeo Kasumi, MD

  • Pain Medicine (Anesthesiology) Physician
  • Falls Church, VA
National Provider Identifier
1356352751
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
0101246858 Issued in VA
Practice address
201 N Washington St
Kaiser Permanente Falls Church Medical Center
Falls Church, VA 22046-4518
Phone
(703) 237-4000
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA08067900 NJ
Anesthesiology Physician 207L00000X 0101246858 VA
Pain Medicine (Anesthesiology) Physician 207LP2900X 244484 NY
Pain Medicine (Anesthesiology) Physician 207LP2900X A98695 CA
Pain Medicine (Anesthesiology) Physician 207LP2900X MD038530 DC
Pain Medicine (Anesthesiology) Physician 207LP2900X D70091 MD
Pain Medicine (Anesthesiology) Physician 207LP2900X 0101246858 VA Primary

Addresses

Primary practice location

201 N Washington St
Kaiser Permanente Falls Church Medical Center
Falls Church, VA 22046-4518

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Other identifiers 4

IdentifierTypeStateIssuer
244484OtherNYNY STATE MEDICAL LICENSE
25MA08067900OtherNJLICENSE
017440OtherMESTATE LICENSE
A98695OtherCASTATE LICENSE

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 DC, MD2 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
I20100608000742 DC Practitioner - Anesthesiology 7517963630 Reassigns benefits to 1 organization
I20200528002815 MD Practitioner - Anesthesiology 7517963630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Temple University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Company LLCGroup PAC ID 4587559026, 373 clinicians

Practice addresses (Care Compare)

8118 Good Luck Rd
Lanham, MD 20706-3574
Phone (301) 552-8118

8905 Fairview Rd
Silver Spring, MD 20910-4150
Phone (888) 554-0631

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08067900NJMDSpecialist
D70091MDMDPain Medicine (Anesthesiology) Physician
244484NYMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Company, LLC Anesthesiology CurrentSince Apr 1, 2024 Accepting new patients
Shore Gastroenterology Associates PC Specialist Past Accepting new patients
Ocean Surgical Pavilion, PC Past Accepting new patients
Pain Management Consultants a Professional Medical Corporation PastSince Jan 1, 1998 Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

70 Sherry Ln
Ste 101
Prnc Frederck, MD 20678
Phone (410) 889-2040

8905 Fairview Rd
Silver Spring, MD 20910
Phone (888) 554-0631

Organizations & group practices 4

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 1

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1356352751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N WASHINGTON ST",
            "address_2": "KAISER PERMANENTE FALLS CHURCH MEDICAL CENTER",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220464518",
            "telephone_number": "703-237-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASUMI",
        "first_name": "TAKEO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA08067900",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101246858",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "244484",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A98695",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "DC",
            "license": "MD038530",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": "D70091",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0101246858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE MEDICAL LICENSE",
            "identifier": "244484",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MA08067900",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "017440",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A98695",
            "state": "CA"
        }
    ],
    "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": "8008 Westpark Dr",
            "city": "Mc Lean",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221023109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.