Active NPI
Natalia Lugina Mauranne, MS, MA, PSYD
- Clinical Neuropsychologist
- Herndon, VA
National Provider Identifier
1528527140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 0810005747
- Practice address
- 441D Carlisle Dr., Suite 103
Herndon, VA 20170-4802 - Phone
- (703) 715-7130
- Fax
- (833) 520-4863
- NPI assigned
- Mar 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 0810005747 | VA | Primary |
Addresses
Primary practice location
441D Carlisle Dr., Suite 103
Herndon, VA 20170-4802
Mailing address
11446 Hollow Timber CT
Reston, VA 20194-1980
Phone (571) 529-2663
Other practice location 1
107 Carpenter Dr Ste 110
Sterling, VA 20164-4468
Phone (703) 297-4368
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
441 -D Carlisle Dr
Suite 103
Herndon, VA 20170-4802
Phone (703) 715-7130
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005747 | VA | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reston Precision Neuropsychology LLC | Clinical Neuropsychologist | Current | Accepting new patients |
Locations
441 Carlisle Dr
Ste 103
Herndon, VA 20170
Phone (703) 715-7130
Organizations & group practices 1
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": "1552435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1528527140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11446 HOLLOW TIMBER CT",
"city": "RESTON",
"state": "VA",
"postal_code": "201941980",
"telephone_number": "571-529-2663",
"fax_number": "833-520-4863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441D CARLISLE DR., SUITE 103",
"city": "HERNDON",
"state": "VA",
"postal_code": "201704802",
"telephone_number": "703-715-7130",
"fax_number": "833-520-4863"
}
],
"practiceLocations": [
{
"address_1": "107 Carpenter Dr Ste 110",
"address_purpose": "LOCATION",
"city": "Sterling",
"state": "VA",
"postal_code": "201644468",
"country_code": "US",
"telephone_number": "703-297-4368",
"fax_number": "571-512-7955",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUGINA MAURANNE",
"first_name": "NATALIA",
"credential": "MS, MA, PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-13",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "VA",
"license": "0810005747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Herndon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.