Individual provider Active NPI

Bryan Arthur Ennis, MD

  • Internal Medicine Physician
  • Arlington, VA
National Provider Identifier
1467613208
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0116020225 Issued in VA
Practice address
1625 N George Mason Dr
Arlington, VA 22205-3683
Phone
(703) 717-4400
NPI assigned
Jun 24, 2008
Last updated
Jul 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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 0116020225 VA Primary

Addresses

Primary practice location

1625 N George Mason Dr
Arlington, VA 22205-3683

Mailing address

1625 N George Mason Dr
Suite 425
Arlington, VA 22205-3683
Phone (703) 717-4400

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
I20120510000376 DC Practitioner - Internal Medicine 4688836547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1625 N George Mason Dr
425 VHC Phy GRP OB Hospitalists
Arlington, VA 22205-3686
Phone (703) 717-4502

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.33 of 100Reported as group
Quality
74.39
Promoting interoperability
87
Improvement activities
40
Cost
70.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116020225VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Hospital Center Physician Group, LLC Current Accepting new patients
Virginia Hospital Center Physician Group LLC CurrentSince May 1, 2012 Accepting new patients
Virginia Hospital Center Physician Group, LLC CurrentSince May 1, 2012 Accepting new patients

Locations

1625 N George Mason Dr
Ste 425
Arlington, VA 22205
Phone (703) 717-4400

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

Interoperability endpoints

  • Direct secure messaging: bennis11405@direct.virginiahospitalcenter.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1467613208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N GEORGE MASON DR",
            "address_2": "SUITE 425",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053683",
            "telephone_number": "703-717-4400",
            "fax_number": "703-717-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N GEORGE MASON DR",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053683",
            "telephone_number": "703-717-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "BRYAN",
        "middle_name": "ARTHUR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116020225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.