Individual provider Active NPI

Kumaresan Sankaran, M.D.

  • Internal Medicine Physician
  • Fairfax, VA
National Provider Identifier
1386731172
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101057791 Issued in VA
Practice address
2812 Old Lee Hwy Ste 210B
Fairfax, VA 22031-4367
Phone
(703) 876-6131
Fax
(703) 876-6009
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101057791 VA Primary

Addresses

Primary practice location

2812 Old Lee Hwy Ste 210B
Fairfax, VA 22031-4367

Mailing address

2812 Old Lee Hwy Ste 210B
Fairfax, VA 22031-4367
Phone (703) 876-6131

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
I20101221000994 DC Practitioner - Internal Medicine 9537357389 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101057791VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services Internal Medicine Current Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients

Locations

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

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

Organizations & group practices 2

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1386731172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 OLD LEE HWY STE 210B",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314367",
            "telephone_number": "703-876-6131",
            "fax_number": "703-876-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 OLD LEE HWY STE 210B",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314367",
            "telephone_number": "703-876-6131",
            "fax_number": "703-876-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANKARAN",
        "first_name": "KUMARESAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101057791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.