Individual provider Active NPI

Frank Procaccino, MD

  • Gastroenterology Physician
  • Woodbridge, VA
National Provider Identifier
1477658193
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101055818 Issued in VA
Practice address
14010 Smoketown Rd Ste 117
Woodbridge, VA 22192-4722
Phone
(703) 580-0181
Fax
(703) 897-8763
NPI assigned
Sep 14, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101055818 VA Primary

Addresses

Primary practice location

14010 Smoketown Rd Ste 117
Woodbridge, VA 22192-4722

Mailing address

14010 Smoketown Rd Ste 117
Woodbridge, VA 22192-4722
Phone (703) 580-0181

Other practice location 1

4660 Kenmore Ave Ste 200
Alexandria, VA 22304-1306
Phone (703) 823-3750

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
I20110613000728 DC Practitioner - Gastroenterology 2860679172 Reassigns benefits to 1 organization
I20140317000874 VA Practitioner - Gastroenterology 2860679172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
George Washington University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastroenterology Associates of Northern Virginia, LLCGroup PAC ID 1759371008, 98 clinicians

Practice addresses (Care Compare)

1800 N Beauregard St
Suite 200
Alexandria, VA 22311-1725
Phone (703) 823-3750

3022 Williams Dr
Suite 301
Fairfax, VA 22031-4600
Phone (703) 698-8960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.52 of 100Reported as group
Quality
56.13
Promoting interoperability
98
Improvement activities
40
Cost
80.61

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy64
Upper gastrointestinal (GI) endoscopy for acid reflux52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101055818VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Northern Virginia, LLC Gastroenterology CurrentSince Oct 1, 2020 Accepting new patients
Old Dominion Anesthesia LLC Past Accepting new patients

Locations

1800 N Beauregard St
Ste 200
Alexandria, VA 22311
Phone (703) 823-3750

2616 Sherwood Hall Ln
Ste 203
Alexandria, VA 22306
Phone (703) 360-0594

4660 Kenmore Ave
Ste 810
Alexandria, VA 22304
Phone (703) 823-0333

3022 Williams Dr
Ste 301
Fairfax, VA 22031
Phone 7032959360121

8140 Ashton Ave
Ste 212
Manassas, VA 20109
Phone (703) 365-9085

422 Garrisonville Rd
Ste 109
Stafford, VA 22554
Phone (540) 659-9359

24570 Medical Dr
Sterling, VA 20166
Phone (571) 367-4400

14010 Smoketown Rd
Ste 117
Woodbridge, VA 22192
Phone (703) 688-4099

Interoperability endpoints

  • Direct secure messaging: frank.procaccino@gastrohealth.eclinicaldirectplus.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1477658193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD STE 117",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924722",
            "telephone_number": "703-580-0181",
            "fax_number": "703-897-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD STE 117",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924722",
            "telephone_number": "703-580-0181",
            "fax_number": "703-897-8763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 Kenmore Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223041306",
            "country_code": "US",
            "telephone_number": "703-823-3750",
            "fax_number": "703-823-3766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROCACCINO",
        "first_name": "FRANK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101055818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.