Organization Active NPI

Robert a. Nussbaum, MD, P.C.

  • Gastroenterology Physician
  • Alexandria, VA
National Provider Identifier
1598041477
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101047887 Issued in VA
Legal business name
ROBERT A. NUSSBAUM, MD, P.C.
Practice address
6355 Walker LN
Ste 309
Alexandria, VA 22310-3247
Phone
(703) 313-8400
Fax
(703) 313-9666
NPI assigned
Oct 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Authorized official

Name
Dr. Robert A Nussbaum, M.D.NPI 1659364511
Title
President
Phone
(703) 313-8400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 0101047887 VA Primary

Addresses

Primary practice location

6355 Walker LN
Ste 309
Alexandria, VA 22310-3247

Mailing address

6355 Walker LN
Ste 309
Alexandria, VA 22310-3247
Phone (703) 313-8400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111227000611 DC Part B Supplier - Clinic/Group Practice 7012183957 Receives reassigned benefits from 1 practitioner
Practice locations: Alexandria, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0968758Robert a Nussbaum MD PC6355 Walker Lane - Suite 309, Alexandria, VA 22310Certificate of waiverDec 20, 2027

National Provider Directory

National Provider Directory

Locations

6355 Walker Ln
Ste 309
Alexandria, VA 22310
Phone (703) 313-8400

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8534/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1598041477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN",
            "address_2": "STE 309",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103247",
            "telephone_number": "703-313-8400",
            "fax_number": "703-313-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN",
            "address_2": "STE 309",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103247",
            "telephone_number": "703-313-8400",
            "fax_number": "703-313-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A. NUSSBAUM, MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-24",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "NUSSBAUM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-313-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101047887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.