Concertohealth of Northern Virginia, LLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC

Practice address

1901 N Beauregard St Ste 110
Alexandria, VA 22311-1721

Phone

(313) 407-3807

NPI assigned

Feb 18, 2021

Organization subpart

Yes

Parent organization

PERFECT HEALTH INCAs reported in NPPES

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

Authorized official

Name

Jose Alfredo Martinez

Title

Director

Phone

(949) 668-4902

Specialties & licenses 1

Addresses

Other names 1

• Cherry Blossom PACE Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1467045682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21750 HARDY OAK BLVD STE 104",
            "address_2": "PMB 72961",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N BEAUREGARD ST STE 110",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111721",
            "telephone_number": "313-407-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERFECT HEALTH INC",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ALFREDO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "949-668-4902"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherry Blossom PACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• PACE Provider Organization in Alexandria, VA
• Providers in Alexandria, VA by specialty
• PACE Provider Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.