Individual provider Active NPI

Charu Gupta, PA-C

  • Physician Assistant
  • Leesburg, VA
National Provider Identifier
1477052603
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-006062 Issued in VA
Practice address
635 Potomac Station Dr NE
Leesburg, VA 20176-1818
Phone
(703) 840-1396
NPI assigned
Feb 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-006062 VA Primary

Addresses

Primary practice location

635 Potomac Station Dr NE
Leesburg, VA 20176-1818

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263

Other practice location 1

3918 Centreville Rd
Chantilly, VA 20151-3224
Phone (703) 657-6925

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180328002039 DC Practitioner - Physician Assistant 7517229701 Reassigns benefits to 1 organization
I20180424000523 VA Practitioner - Physician Assistant 7517229701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10100 Fairfax Blvd
Fairfax, VA 22030-2000
Phone (703) 679-1876

1260 Temple Ave
Colonial Heights, VA 23834-2984
Phone (804) 518-2597

14800 Lee Hwy
Gainesville, VA 20155-1842
Phone (703) 743-7017

2199 Old Bridge Rd
Woodbridge, VA 22192-2911
Phone (703) 357-9707

2304 W Mercury Blvd
Hampton, VA 23666-3115
Phone (757) 951-1579

3918 Centreville Rd
Chantilly, VA 20151-3224
Phone (703) 657-6925

47100 Community PLZ
Suite 100
Sterling, VA 20164-1821
Phone (703) 880-1403

601 Potomac Station Dr
Leesburg, VA 20176-1816
Phone (703) 840-1396

6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087

9715 Liberia Ave
Manassas, VA 20110-5837
Phone (571) 229-1797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110-006062VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC CurrentSince Feb 5, 2018 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Feb 5, 2018 Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

3918 Centreville Rd
Chantilly, VA 20151
Phone (703) 657-6925

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

Interoperability endpoints

  • Direct secure messaging: vaexchange@patientfirstclinics.com

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1477052603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 POTOMAC STATION DR NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201761818",
            "telephone_number": "703-840-1396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3918 Centreville Rd",
            "address_purpose": "LOCATION",
            "city": "Chantilly",
            "state": "VA",
            "postal_code": "201513224",
            "country_code": "US",
            "telephone_number": "703-657-6925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "CHARU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-006062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3918 Centreville Rd",
            "city": "Chantilly",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201513224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.