Individual provider Active NPI

Priyadarshan K. Tulsi, M.D.

  • Pediatrics Physician
  • Manassas, VA
National Provider Identifier
1487604039
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101237322 Issued in VA
Practice address
9430 Forestwood LN
100
Manassas, VA 20110-4753
Phone
(703) 365-0227
Fax
(703) 365-0332
NPI assigned
May 12, 2006
Last updated
Feb 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101237322 VA Primary

Addresses

Primary practice location

9430 Forestwood LN
100
Manassas, VA 20110-4753

Mailing address

PO Box 748613
Atlanta, GA 30384-8613

Other identifiers 7

IdentifierTypeStateIssuer
5625017OtherVAFIRST HEALTH/CCN
7015450OtherVAAETNA PROVIDER NUMBER
B337-0003OtherVACARE FIRST BLUE CROSS
2399249OtherVAUNITED HEALTHCARE
708975OtherVANCPPO
010128234MedicaidVA
8132829OtherVAMAMSI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ptulsi306936@direct.novanthealth.org

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
I20160822001629 VA Practitioner - Pediatric Medicine 1951696558 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101237322VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Pediatrics CurrentSince Jul 22, 2016 Accepting new patients
Uva Community Health Medical Group, LLC Pediatrics CurrentSince Jul 30, 2020 Accepting new patients
Uva Community Health Medical Group, LLC CurrentSince Jul 30, 2020 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 22, 2016 Accepting new patients
Uva Community Health Medical Group, LLC Past Accepting new patients

Locations

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

8644 Sudley Rd
#220
Manassas, VA 20110

9430 Forestwood Ln
Ste 100
Manassas, VA 20110
Phone (571) 284-1430

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1487604039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748613",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 FORESTWOOD LN",
            "address_2": "100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104753",
            "telephone_number": "703-365-0227",
            "fax_number": "703-365-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULSI",
        "first_name": "PRIYADARSHAN",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101237322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH/CCN",
            "identifier": "5625017",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7015450",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST BLUE CROSS",
            "identifier": "B337-0003",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2399249",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "708975",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010128234",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "8132829",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptulsi306936@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "9430 Forestwood Ln",
            "address_2": "100",
            "city": "Manassas",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201104753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.