Active NPI
Errol Segall, MD
- Psychiatry Physician
- Fairfax, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101031662
- Practice address
- 8500 Executive Park Ave
Suite 200
Fairfax, VA 22031-2225 - Phone
- (703) 698-5220
- Fax
- (703) 573-2351
- NPI assigned
- Jul 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101031662 | VA | Primary |
| Psychiatry Physician | 2084P0800X | D0042679 | MD |
Addresses
Primary practice location
8500 Executive Park Ave
Suite 200
Fairfax, VA 22031-2225
Mailing address
8500 Executive Park Ave
Suite 200
Fairfax, VA 22031-2225
Phone (703) 698-5220
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 513455 | Other | VA | NCPPO |
| 032028 | Other | VA | VALUE OPTIONS |
| 520045 | Other | MAMSI | |
| 403200400 | Medicaid | MD | |
| 4137282 | Other | AETNA | |
| 0001 | Other | DC | CAREFIRST NCA |
| 110142-000 | Other | VA | MAGELLAN |
| 153479 | Other | VA | ANTHEM |
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: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Wisconsin School of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
8500 Executive Park Ave
Fairfax, VA 22031-2228
Phone (703) 698-5220
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0042679 | MD | MD | Psychiatry Physician |
| 0101031662 | VA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Virginia Psychiatric Group | Psychiatry | Current | Accepting new patients |
| Meditelecare of Virginia, LLC | Psychiatry | Current | Accepting new patients |
Locations
4242 Medical Dr
Ste 7100
San Antonio, TX 78229
Phone (210) 342-1906
8500 Executive Park Ave
Ste 200
Fairfax, VA 22031
Phone (703) 698-5200
836 Glendale Rd
Galax, VA 24333
Phone (276) 236-9991
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
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": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320883200000",
"number": "1407855190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8500 EXECUTIVE PARK AVE",
"address_2": "SUITE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312225",
"telephone_number": "703-698-5220",
"fax_number": "703-573-2351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 EXECUTIVE PARK AVE",
"address_2": "SUITE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312225",
"telephone_number": "703-698-5220",
"fax_number": "703-573-2351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEGALL",
"first_name": "ERROL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-15",
"last_updated": "2011-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101031662",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0042679",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO",
"identifier": "513455",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "032028",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "520045",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "403200400",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4137282",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST NCA",
"identifier": "0001",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "110142-000",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "153479",
"state": "VA"
}
],
"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 Nov 10, 2011; 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.