Individual provider Active NPI

John J. Fainsan, MSPT, CSCS

  • Physical Therapist
  • Reston, VA
National Provider Identifier
1548211840
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305207532 Issued in VA
Practice address
11800 Sunrise Valley Dr
100
Reston, VA 20191
Phone
(703) 709-1116
Fax
(703) 709-5134
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9576 CO
Physical Therapist 225100000X 2305207532 VA Primary

Addresses

Primary practice location

11800 Sunrise Valley Dr
100
Reston, VA 20191

Mailing address

11800 Sunrise Valley Dr Ste 100
Reston, VA 20191-5309
Phone (703) 709-1116

Other identifiers 1

IdentifierTypeStateIssuer
9576OtherCOPHYSICAL THERAPY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130102000447 DC Practitioner - Physical Therapist in Private Practice 7315958758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Virginia Therapy and Fitness CenterGroup PAC ID 3072680628, 11 clinicians

Practice addresses (Care Compare)

11800 Sunrise Valley Dr
Suite 100
Reston, VA 20191-5309
Phone (703) 709-1116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9576COMDSpecialist
2305207532VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy & Industrial Services PC Specialist PastSince Sep 9, 2011 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1548211840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 SUNRISE VALLEY DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201915309",
            "telephone_number": "703-709-1116",
            "fax_number": "703-709-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 SUNRISE VALLEY DR",
            "address_2": "100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20191",
            "telephone_number": "703-709-1116",
            "fax_number": "703-709-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAINSAN",
        "first_name": "JOHN",
        "middle_name": "J.",
        "credential": "MSPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "9576",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "9576",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.