Active NPI
Daseuli Jeong
- Obesity Medicine (Family Medicine) Physician
- Fairfax, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity Medicine (Family Medicine) Physician
- License
- 0024194635
- Practice address
- 3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944 - Phone
- (703) 865-6490
- NPI assigned
- Aug 22, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Family Medicine) Physician | 207QB0002X | 0024194635 | VA | Primary |
Addresses
Primary practice location
3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944
Mailing address
3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944
Phone (703) 865-6490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3025 Berkmar Dr
Suite 1
Charlottesville, VA 22901-1456
Phone (434) 973-1831
3903 Fair Ridge Dr
Suite 219
Fairfax, VA 22033-2945
Phone (703) 865-6490
4820 31St St S
Suite B
Arlington, VA 22206-1665
Phone (703) 865-6490
8130 Boone Blvd
Suite 110
Vienna, VA 22182-2640
Phone (571) 982-6636
8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845
9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800
950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024194635 | VA | MD | Obesity Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group, LLC | Current | Accepting new patients | |
| Privia Medical Group, LLC | Current | Accepting new patients | |
| Nova Physician Wellness Center PLLC | Past | Accepting new patients |
Locations
9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800
3903 Fair Ridge Dr
Ste 209
Fairfax, VA 22033
Phone (571) 349-2191
8644 Sudley Rd
#220
Manassas, VA 20110
14010 Smoketown Rd
Ste 105
Woodbridge, VA 22192
Phone (703) 730-4848
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
- daseuli.jeong.1@8042.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Pain Medicine (Psychiatry & Neurology) Physician
- Rockville, MD
- NPI 1811715436
-
- Family Medicine Physician
- Fairfax, VA
- NPI 1215307400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757894400000",
"number": "1366320970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3903 FAIR RIDGE DR STE 209",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332944",
"telephone_number": "703-865-6490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3903 FAIR RIDGE DR STE 209",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332944",
"telephone_number": "703-865-6490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEONG",
"first_name": "DASEULI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-22",
"last_updated": "2025-09-15",
"certification_date": "2025-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "207QB0002X",
"taxonomy_group": "",
"desc": "Family Medicine, Obesity Medicine",
"state": "VA",
"license": "0024194635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.