Active NPI
Patricia Youngmee Tae, M.D.
- Pediatrics Physician
- Alexandria, VA
National Provider Identifier
1609074301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 239290
- Practice address
- 6303 Little River Tpke
Suite 300
Alexandria, VA 22312 - Phone
- (703) 914-8989
- Fax
- (703) 914-5494
- NPI assigned
- Jul 5, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 239290 | NY | Primary |
Addresses
Primary practice location
6303 Little River Tpke
Suite 300
Alexandria, VA 22312
Mailing address
6303 Little River Tpke
Suite 300
Alexandria, VA 22312
Phone (703) 914-8989
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 239290 | Other | NY | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239290 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Medical Associates of Northern Virginia, P.C. | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BFDEBD/Endpoint/BFDEBD
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.
-
- Pediatrics Physician
- Alexandria, VA
- NPI 1255450722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259625600000",
"number": "1609074301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6303 LITTLE RIVER TPKE",
"address_2": "SUITE 300",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "22312",
"telephone_number": "703-914-8989",
"fax_number": "703-914-5494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6303 LITTLE RIVER TPKE",
"address_2": "SUITE 300",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "22312",
"telephone_number": "703-914-8989",
"fax_number": "703-914-5494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAE",
"first_name": "PATRICIA",
"middle_name": "YOUNGMEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-05",
"last_updated": "2009-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "239290",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "239290",
"state": "NY"
}
],
"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 Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.