Active NPI
Bruce W Pfeffer, MD
- Pediatrics Physician
- Springfield, VA
National Provider Identifier
1639254691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101024712
- Practice address
- 8316 Traford LN
Springfield, VA 22152 - Phone
- (703) 569-8400
- Fax
- (703) 569-1182
- NPI assigned
- Oct 26, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 0101024712 | VA | Primary |
Addresses
Primary practice location
8316 Traford LN
Springfield, VA 22152
Mailing address
8316 Traford LN
Springfield, VA 22152
Phone (703) 569-8400
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 840880 | Other | OPTIMUM CHOICE | |
| 4089488 | Other | AETNA PPO | |
| 876746 | Other | AETNA HMO | |
| 4089488 | Other | AETNA POS | |
| B9390003 | Other | CARE FIRST BCBS | |
| 10387813 | Other | CAQH | |
| 840880 | Other | MAMSI | |
| 840880 | Other | MD IPA |
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 |
|---|---|---|---|
| 0101024712 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639254691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8316 TRAFORD LN",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "22152",
"telephone_number": "703-569-8400",
"fax_number": "703-569-1182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8316 TRAFORD LN",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "22152",
"telephone_number": "703-569-8400",
"fax_number": "703-569-1182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFEFFER",
"first_name": "BRUCE",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101024712",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM CHOICE",
"identifier": "840880",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4089488",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "876746",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA POS",
"identifier": "4089488",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST BCBS",
"identifier": "B9390003",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "10387813",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "840880",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD IPA",
"identifier": "840880",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.