Individual provider Active NPI

Suraj S Venna, MD

  • Dermatology Physician
  • Fairfax, VA
National Provider Identifier
1366433302
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101255078 Issued in VA
Practice address
8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone
(571) 472-4724
Fax
(571) 472-0241
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 218355 MA
Dermatology Physician 207N00000X 0101255078 VA Primary

Addresses

Primary practice location

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Mailing address

8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone (571) 472-4724

Other practice location 1

8505 Arlington Blvd Ste 140
Fairfax, VA 22031-4636
Phone (703) 970-6430

Other identifiers 1

IdentifierTypeStateIssuer
2100550MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address svenna142136@soc.inova.org Health Information Exchange (HIE)

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
I20090902000618 DC Practitioner - Dermatology 4688600414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Boston University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision18
Removal of skin lesions149
Removal or shaving of skin growth116
Skin biopsy36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218355MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Nov 3, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Boston University Dermatology, Inc. Dermatology Past Accepting new patients
Inova Health Care Services Past Accepting new patients
Evans Medical Foundation, Inc. Past Accepting new patients

Locations

8081 Innovation Park Dr
Ste 301
Fairfax, VA 22031
Phone (571) 472-6431

8081 Innovation Park Dr
Fl 1
Fairfax, VA 22031
Phone (571) 472-4724

8505 Arlington Blvd
Ste 140
Fairfax, VA 22031
Phone (703) 207-0733

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Interoperability endpoints

  • Direct secure messaging: svenna142136@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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1366433302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-4724",
            "fax_number": "571-472-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-4724",
            "fax_number": "571-472-0241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8505 Arlington Blvd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314636",
            "country_code": "US",
            "telephone_number": "703-970-6430",
            "fax_number": "703-970-6428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENNA",
        "first_name": "SURAJ",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "218355",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101255078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100550",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "svenna142136@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8081 Innovation Park Dr",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.