Individual provider Active NPI

Daniel Richard Fisk, M.D.

  • Obstetrics & Gynecology Physician
  • Fairfax, VA
National Provider Identifier
1518050558
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101228931 Issued in VA
Practice address
4001 Fair Ridge Dr Ste 304
Fairfax, VA 22033-2917
Phone
(703) 861-5564
Fax
(703) 549-3642
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0101228931 VA Primary

Addresses

Primary practice location

4001 Fair Ridge Dr Ste 304
Fairfax, VA 22033-2917

Mailing address

4001 Fair Ridge Dr Ste 304
Fairfax, VA 22033-2917
Phone (703) 861-5564

Other identifiers 1

IdentifierTypeStateIssuer
010141273MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20040714001250 DC Practitioner - Obstetrics/Gynecology 2466431408 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services Obstetrics & Gynecology Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3650 Joseph Siewick Dr
Ste 203
Fairfax, VA 22033
Phone (703) 391-1500

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Interoperability endpoints

  • Direct secure messaging: daniel.fisk@tfc.directbygreenway.com

Organizations & group practices 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1518050558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR STE 304",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-861-5564",
            "fax_number": "703-549-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR STE 304",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-861-5564",
            "fax_number": "703-549-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "DANIEL",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101228931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010141273",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.