Individual provider Active NPI

Rosy Gautam

  • Family Nurse Practitioner
  • Falls Church, VA
National Provider Identifier
1376209742
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024180585 Issued in VA
Practice address
2901 Telestar CT Ste 200
Falls Church, VA 22042-1262
Phone
(703) 573-3494
Fax
(703) 573-5353
NPI assigned
Nov 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0024180585 VA
Family Nurse Practitioner 363LF0000X 0024180585 VA Primary

Addresses

Primary practice location

2901 Telestar CT Ste 200
Falls Church, VA 22042-1262

Mailing address

6760 Joseph Edgar CT
Alexandria, VA 22310-2667
Phone (703) 217-4382

Other practice location 1

6760 Joseph Edgar Ct
Alexandria, VA 22310-2667
Phone (703) 217-4382

Other identifiers 1

IdentifierTypeStateIssuer
0024180585OtherVALICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL rosy.pahade@gmail.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230210000967 VA Practitioner - Nurse Practitioner 9931571379 Reassigns benefits to 1 organization
I20230213001364 DC Practitioner - Nurse Practitioner 9931571379 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024180585VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Dec 11, 2022 Accepting new patients
Inova Health Care Services Internal Medicine CurrentSince Dec 11, 2022 Accepting new patients
My29Care CurrentSince Oct 1, 2023 Accepting new patients

Locations

2901 Telestar Ct
Ste 200
Falls Church, VA 22042
Phone (703) 573-3494

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

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Interoperability endpoints

  • Direct secure messaging: rgautam1115194@soc.inova.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1376209742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6760 JOSEPH EDGAR CT",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223102667",
            "telephone_number": "703-217-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 TELESTAR CT STE 200",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421262",
            "telephone_number": "703-573-3494",
            "fax_number": "703-573-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6760 Joseph Edgar Ct",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223102667",
            "country_code": "US",
            "telephone_number": "703-217-4382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "ROSY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0024180585",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0024180585",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rosy.pahade@gmail.com",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6760 Joseph Edgar Ct",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223102667",
            "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.