Individual provider Active NPI

Daniel Macleod Fistere Jr., M.D.

  • Diagnostic Radiology Physician
  • Fairfax, VA
National Provider Identifier
1528358199
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101263565 Issued in VA
Practice address
2722 Merrilee Dr
Ste 230
Fairfax, VA 22031-4400
Phone
(703) 698-4488
NPI assigned
Apr 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101263565 VA Primary
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 287924-1 NY

Addresses

Primary practice location

2722 Merrilee Dr
Ste 230
Fairfax, VA 22031-4400

Mailing address

2722 Merrilee Dr
Ste 230
Fairfax, VA 22031-4400
Phone (703) 698-4444

Other practice location 1

1275 York Ave
Department of Radiology
New York, NY 10065-6007
Phone (212) 639-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 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
I20180621001775 DC Practitioner - Diagnostic Radiology 6002119070 Reassigns benefits to 3 organizations
I20180718001423 VA Practitioner - Diagnostic Radiology 6002119070 Reassigns benefits to 3 organizations
I20200325001291 MD Practitioner - Diagnostic Radiology 6002119070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ifrc LLCGroup PAC ID 2961829882, 135 clinicians
Fairfax Radiological ConsultantsGroup PAC ID 8628970324, 151 clinicians
Inova Reston MRI Center LLCGroup PAC ID 2961540042, 101 clinicians

Practice addresses (Care Compare)

100 Elden St
Suite 16
Herndon, VA 20170-4841
Phone (703) 698-4488

11335 Pembrooke SQ
Waldorf, MD 20603-4845
Phone (703) 698-4488

19455 Deerfield Ave
Suite 102
Leesburg, VA 20176-8102
Phone (703) 698-4488

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 698-4444

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 698-4444

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6470

450 Springpark PL
Suite 100
Herndon, VA 20170-5269
Phone (703) 481-9400

8926 Woodyard Rd
Suite 301
Clinton, MD 20735-4232
Phone (703) 698-4488

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
15 of 100Reported as group
Quality
0
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
28.96 of 100Reported as group
Quality
16.43
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
67.5 of 100Reported as group
Quality
58.12
Improvement activities
40
Cost
68.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287924-1NYMDDiagnostic Neuroimaging (Radiology) Physician
0101263565VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jan 21, 2019 Accepting new patients
Inova Reston MRI Center LLC Diagnostic Radiology CurrentSince Jun 2, 2018 Accepting new patients
Fairfax Radiological Consultants Diagnostic Neuroimaging CurrentSince Jul 12, 2018 Accepting new patients
Ifrc, LLC CurrentSince Sep 1, 2020 Accepting new patients
Inova Reston MRI Center LLC CurrentSince Jun 2, 2018 Accepting new patients
Inova Health Care Services Current Accepting new patients

Locations

8926 Woodyard Rd
Ste 301
Clinton, MD 20735
Phone (301) 856-3670

230 W Dares Beach Rd
Ste 100
Prnc Frederck, MD 20678
Phone (301) 855-9754

11335 Pembrooke Sq
#101
Waldorf, MD 20603
Phone (301) 856-6718

2722 Merrilee Dr
Ste 230
Fairfax, VA 22031

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

100 Elden St
Ste 16M
Herndon, VA 20170
Phone (703) 481-9400

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

19455 Deerfield Ave
Ste 102
Leesburg, VA 20176
Phone (703) 858-0001

4 Pidgeon Hill Dr
Sterling, VA 20165
Phone (703) 433-9230

Interoperability endpoints

  • Direct secure messaging: dfistere585845@soc.inova.org

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1528358199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "STE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314400",
            "telephone_number": "703-698-4444",
            "fax_number": "703-204-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "STE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314400",
            "telephone_number": "703-698-4488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_2": "Department of Radiology",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "212-639-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISTERE",
        "first_name": "DANIEL",
        "middle_name": "MACLEOD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-15",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101263565",
            "primary": true
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "NY",
            "license": "287924-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.