Individual provider Active NPI

Errol Segall, MD

  • Psychiatry Physician
  • Fairfax, VA
National Provider Identifier
1407855190
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101031662 Issued in VA
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

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
513455OtherVANCPPO
032028OtherVAVALUE OPTIONS
520045OtherMAMSI
403200400MedicaidMD
4137282OtherAETNA
0001OtherDCCAREFIRST NCA
110142-000OtherVAMAGELLAN
153479OtherVAANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110425000429 DC Practitioner - Psychiatry 8022290543 Reassigns benefits to 1 organization
I20120210000013 VA Practitioner - Psychiatry 8022290543 Reassigns benefits to 2 organizations

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
Northern Virginia Psychiatric GroupGroup PAC ID 9830184852, 11 clinicians

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

LicenseStateTypeSpecialty
D0042679MDMDPsychiatry Physician
0101031662VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Virginia Psychiatric Group Psychiatry CurrentSince Oct 1, 1981 Accepting new patients
Meditelecare of Virginia, LLC Psychiatry CurrentSince Mar 1, 2018 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

  • FHIR API: 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

Verify at the official NPI Registry.