NPIMap

Organization Active NPI

Virginia Spine Specialists, PLLC

  • Neurological Surgery Physician
  • Manassas, VA
National Provider Identifier
1508130246
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
VIRGINIA SPINE SPECIALISTS, PLLC
Practice address
9625 Surveyor Court
Suite 320
Manassas, VA 20110-4408
Phone
(571) 921-4877
Fax
(571) 208-0585
NPI assigned
Feb 27, 2012
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Mr. Mudit Sharma, MDNPI 1285700369
Title
Owner
Phone
(571) 921-4877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X Primary

Addresses

Primary practice location

9625 Surveyor Court
Suite 320
Manassas, VA 20110-4408

Mailing address

9625 Surveyor Court
Suite 320
Manassas, VA 20110-4408
Phone (571) 921-4877

Other practice location 1

4604 Spotsylvania Pkwy Ste 300
Fredericksburg, VA 22408-7766
Phone (571) 921-4877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20120412000502 VA Part B Supplier - Clinic/Group Practice 0840451100 Receives reassigned benefits from 8 practitioners
Practice locations: Dulles, VA; Fredericksburg, VA; Manassas, VA
O20140611000328 DC Part B Supplier - Clinic/Group Practice 0840451100 Receives reassigned benefits from 5 practitioners
Practice locations: Bethesda, MD; Fairfax, VA
O20220920000543 VA DME Supplier - Physician - Neurosurgery 0840451100 Practice locations: Manassas, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

4604 Spotsylvania Pkwy
Ste 300
Fredericksburg, VA 22408
Phone (540) 423-6600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIBJAD

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1508130246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 SURVEYOR COURT",
            "address_2": "SUITE 320",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104408",
            "telephone_number": "571-921-4877",
            "fax_number": "571-208-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 SURVEYOR COURT",
            "address_2": "SUITE 320",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104408",
            "telephone_number": "571-921-4877",
            "fax_number": "571-208-0585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4604 Spotsylvania Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224087766",
            "country_code": "US",
            "telephone_number": "571-921-4877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIRGINIA SPINE SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "MUDIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-921-4877",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.