Individual provider Active NPI

Jayanta Kumar Dirghangi, M.D.

  • Obstetrics & Gynecology Physician
  • Ashburn, VA
National Provider Identifier
1548333636
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101271612 Issued in VA
Practice address
22505 Landmark CT Ste 210B
Ashburn, VA 20148-6500
Phone
(571) 612-6350
Fax
(571) 612-6351
NPI assigned
Nov 16, 2006
Last updated
Oct 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 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 MD12656 TN
Obstetrics & Gynecology Physician 207V00000X 0101271612 VA Primary

Addresses

Primary practice location

22505 Landmark CT Ste 210B
Ashburn, VA 20148-6500

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

7655 Poplar Ave
Suite 360
Germantown, TN 38138-3995
Phone (901) 752-5666

Other practice location 2

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Other identifiers 1

IdentifierTypeStateIssuer
621415063OtherTNTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20090226000570 TN Practitioner - Obstetrics/Gynecology 4880750892 Reassigns benefits to 1 organization
I20221108001081 VA Practitioner - Obstetrics/Gynecology 4880750892 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12656TNMDClinical Social Worker
MD12656TNMDSpecialist
0101271612VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poplar Avenue Clinic PLLC CurrentSince Jun 25, 2023 Accepting new patients
Weeks Cancer Center PLLC Current Accepting new patients
Inova Health Care Services Obstetrics & Gynecology CurrentSince Jul 28, 2022 Accepting new patients
Inova Health Care Services CurrentSince Jul 28, 2022 Accepting new patients
Tristate OBGYN, PC Obstetrics & Gynecology PastSince Oct 1, 2016 Accepting new patients

Locations

6584 Poplar Ave
Ste 400
Memphis, TN 38138
Phone (901) 300-6713

22505 Landmark Ct
Ste 210B
Ashburn, VA 20148
Phone (571) 612-6350

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

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

Organizations & group practices 5

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1548333636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22505 LANDMARK CT STE 210B",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201486500",
            "telephone_number": "571-612-6350",
            "fax_number": "571-612-6351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7655 Poplar Ave",
            "address_2": "Suite 360",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383995",
            "country_code": "US",
            "telephone_number": "901-752-5666",
            "fax_number": "901-752-3939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44045 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765101",
            "country_code": "US",
            "telephone_number": "703-858-6000",
            "fax_number": "703-858-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIRGHANGI",
        "first_name": "JAYANTA",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD12656",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101271612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "621415063",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.