Erickson Health Medical Group of Virginia PC
Organization Active NPI Internal Medicine Physician · Springfield, VA
NPI 1609896489 · NPPES record last updated Aug 10, 2023
Key facts
- NPI
- 1609896489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- ERICKSON HEALTH MEDICAL GROUP OF VIRGINIA PC
- Practice address
- 7440 Spring Village Dr
Springfield, VA 22150-4446 - Phone
- (703) 923-4644
- Fax
- (703) 923-4625
- NPI assigned
- Jul 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Matthew J Narrett, M.D.
- Title
- Senior VP and Chief Medical Officer
- Phone
- (410) 402-2257
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 3
Practitioners 39
-
Catherine A Buck, NP
-
Rizwan Qadir Dar, M.D.,
-
Kauser Kaleem, NP
-
Matthew John Keast, D.P.M.
-
Tariq Khurshid, MD
-
Shaveta Kotwal, MD
-
Deevya L Narayanan, D.O.
-
Kamaljit Sethi, M.D.
-
Tushar C Shah, MD
-
Kathleen Taylor, LCSW
-
Annie T Thomas, M.D.
-
Blandine Yacinthus, DNP, PMHNP-BC
-
Sejal Patel, DPM
-
Niraj Patel, MD
-
Emmaleona Ego Agogbua, APRN, FNP
-
Huma Naureen Bhatti, M.D.
-
Gauthami Gondy, M.D
-
Peter R. Harding, D.O.
-
Ronald Longo, LCSW
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0954324 | Ehmg of VA Greenspring Medical Center | Provider-performed microscopy | Nov 22, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040406001506 | DC | Part B Supplier - Clinic/Group Practice | 1153314067 |
Receives reassigned benefits from 21 practitioners 1 other NPI on this enrollment Practice locations: Fairfax, VA; Springfield, VA |
National Provider Directory
- Tax ID family
- Erickson Health Medical GRP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X | |||
| Podiatrist |
213E00000X | |||
| Adult Health Nurse Practitioner |
363LA2200X | |||
| Gerontology Nurse Practitioner |
363LG0600X | |||
| Gerontology Clinical Nurse Specialist |
364SG0600X | |||
| Psychiatric/Mental Health Clinical Nurse Specialist |
364SP0808X |
Addresses
Primary practice location
7440 Spring Village Dr
Springfield, VA 22150-4446
Mailing address
5730 Executive Dr Ste 230
Catonsville, MD 21228-1762
Phone (703) 923-4644
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04-53885 | Other | EVERCARE | |
| 350541 | Other | BCBS | |
| LS89SE | Other | BCBS VA | |
| 0006 | Other | CAREFIRST OF DC | |
| 5374 | Other | BCBS DC | |
| 346802 | Other | CAREFIRST OF MD |
Other names
- Greenspring Medical Center
Other providers in Springfield, VA
- ENT Neonatal of Northern Virginia
- Erica Ann Epps
- Bethany C Epstein
- Ericj Furst MD PC
- Erickson Health Medical Group of Virginia PC
- Nathan Eskinder
- Robert N Essien
- Ethel Lea Watson, D.M.D., M.a.,P.C
- Kirsten Caulfield Eure
- Candace E Evans
All providers in Springfield, VA · Internal Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.