Individual provider Active NPI

Pavan Nataraj, MD

  • Allergy & Immunology Physician
  • Alexandria, VA
National Provider Identifier
1508359035
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
036160076 Issued in IL
Practice address
4660 Kenmore Ave Ste 516
Alexandria, VA 22304-1313
Phone
(703) 997-0811
Fax
(703) 997-0820
NPI assigned
Jun 9, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 036160076 IL Primary
Allergy Physician 207KA0200X MD210001682 DC
Internal Medicine Physician 207R00000X MT215920 PA

Addresses

Primary practice location

4660 Kenmore Ave Ste 516
Alexandria, VA 22304-1313

Mailing address

112 Thomas Johnson Dr Ste 210
Frederick, MD 21702-4970
Phone (240) 817-0810

Other practice location 1

2021 K St NW Ste 400
Washington, DC 20006-1009
Phone (202) 833-3500

Other practice location 2

3301 New Mexico Ave NW Ste 305
Washington, DC 20016-3624
Phone (202) 244-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20240524001863 DC Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 4385990282 Reassigns benefits to 1 organization
I20240530003045 MD Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 4385990282 Reassigns benefits to 1 organization
I20260311002099 FL Practitioner - Allergy/Immunology 4385990282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DMV Allergy and Asthma Center LLCGroup PAC ID 7719329515, 7 clinicians
Florida Allergy and Asthma Associates PAGroup PAC ID 7315958089, 7 clinicians

Practice addresses (Care Compare)

112 Thomas Johnson Dr
Suite 210
Frederick, MD 21702-4970
Phone (240) 817-0810

2021 K St NW
Washington, DC 20006-1009
Phone (301) 252-1866

5507 S Congress Ave
Suite 140
Atlantis, FL 33462-1139
Phone (561) 965-6685

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036160076ILMDAllergy & Immunology Physician
MD210001682DCMDAllergy Physician
MT215920PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Allergy and Asthma Associates, PA Allergy & Immunology CurrentSince Oct 21, 2025 Accepting new patients
DMV Allergy and Asthma Center LLC Allergy & Immunology CurrentSince May 1, 2024 Accepting new patients
Henry J Fishman , M.D., P.C. Allergy Past Accepting new patients
DMV Allergy and Asthma Center LLC Allergy & Immunology Past Accepting new patients

Locations

2021 K St NW
Washington, DC 20006
Phone (202) 466-8118

3301 New Mexico Ave NW
Ste 305
Washington, DC 20016
Phone (202) 240-9002

2021 K St NW
Ste 400
Washington, DC 20006
Phone (202) 466-5151

10151 Enterprise Ctr
Ste 175
Boynton Beach, FL 33437

6056 W Boynton Beach Blvd
Ste 175
Boynton Beach, FL 33437
Phone (561) 572-2024

10151 Entrprs Cntr Blvd
Ste 207
Boynton Beach, FL 33437
Phone (561) 735-0250

5507 S Congress Ave
Ste 140
Lantana, FL 33462
Phone (561) 965-6685

112 Thomas Johnson Dr
Ste 210
Frederick, MD 21702
Phone (240) 817-0810

4660 Kenmore Ave
Ste 516
Alexandria, VA 22304
Phone (703) 997-0811

4660 Kenmore Ave
Ste 419
Alexandria, VA 22304
Phone (301) 252-1866

Organizations & group practices 4

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": "1528502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1508359035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 THOMAS JOHNSON DR STE 210",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024970",
            "telephone_number": "240-817-0810",
            "fax_number": "240-817-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 516",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-997-0811",
            "fax_number": "703-997-0820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 K St NW Ste 400",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061009",
            "country_code": "US",
            "telephone_number": "202-833-3500",
            "fax_number": "202-833-3503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3301 New Mexico Ave NW Ste 305",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200163624",
            "country_code": "US",
            "telephone_number": "202-244-9000",
            "fax_number": "202-244-9006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATARAJ",
        "first_name": "PAVAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-09",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036160076",
            "primary": true
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "DC",
            "license": "MD210001682",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT215920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.