Individual provider Active NPI

Amy Lyn Friedenthal, MD

  • Internal Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1427176999
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101047502 Issued in VA
Practice address
125120 D Lakeridge Drive
Woodbridge, VA 22192
Phone
(703) 497-5555
Fax
(703) 497-1479
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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 0101047502 VA Primary

Addresses

Primary practice location

125120 D Lakeridge Drive
Woodbridge, VA 22192

Mailing address

125120 D Lakeridge Drive
Woodbridge, VA 22192
Phone (703) 497-5555

Other identifiers 3

IdentifierTypeStateIssuer
010031427MedicaidVA
0004666397OtherVAAETNA
267008OtherVABLUE CROSS - ANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040123000611 VA Practitioner - Internal Medicine 5395647960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12512 Lake Ridge Dr
Suite D
Woodbridge, VA 22192-2386
Phone (703) 497-5555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.24 of 100Reported as individual
Quality
67.27
Promoting interoperability
100
Improvement activities
40
Cost
83.53

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amy L Friedenthal MD PC Internal Medicine CurrentSince Oct 16, 2003 Accepting new patients

Locations

12512 Lake Ridge Dr
Ste D
Woodbridge, VA 22192
Phone (703) 497-5555

Interoperability endpoints

  • Direct secure messaging: amy.friedenthal.1@4363.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/4363/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 1

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1427176999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125120 D LAKERIDGE DRIVE",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-497-5555",
            "fax_number": "703-684-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125120 D LAKERIDGE DRIVE",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-497-5555",
            "fax_number": "703-497-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDENTHAL",
        "first_name": "AMY",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101047502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010031427",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004666397",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS - ANTHEM",
            "identifier": "267008",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.