Individual provider Active NPI

Harsh Datta, MD

  • Neonatal-Perinatal Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1679734412
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
0101242983 Issued in VA
Practice address
15204 Spotted Turtle CT
Woodbridge, VA 22193-5876
Phone
(703) 625-9213
NPI assigned
Jun 24, 2008
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 25MA10707600 NJ
Neonatal-Perinatal Medicine Physician 2080N0001X D0073607 MD
Neonatal-Perinatal Medicine Physician 2080N0001X 0101242983 VA Primary

Addresses

Primary practice location

15204 Spotted Turtle CT
Woodbridge, VA 22193-5876

Mailing address

15204 Spotted Turtle CT
Woodbridge, VA 22193-5876
Phone (703) 625-9213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NJ2 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
I20120710000135 DC Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8022273465 Reassigns benefits to 1 organization
I20241219004313 NJ Practitioner - Pediatric Medicine 8022273465 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0073607MDMDNeonatal-Perinatal Medicine Physician
25MA10707600NJMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nemours New Jersey Physician Practice, P.C. CurrentSince Dec 1, 2024 Accepting new patients
Children's Hospital CurrentSince Jun 18, 2018 Accepting new patients
Children's Hospital CurrentSince Jun 18, 2018 Accepting new patients
Children's Hospital Current Accepting new patients
Kennedy University Hospital Inc. Past Accepting new patients
Pediatrix Medical Group of Texas Billing, Inc. Neonatal-Perinatal Medicine Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

700 Mullica Hill Rd
Mullica Hill, NJ 08062
Phone (856) 508-1000

1280 Almonesson Rd
Woodbury, NJ 08096
Phone (856) 345-1401

Organizations & group practices 6

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1679734412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15204 SPOTTED TURTLE CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935876",
            "telephone_number": "703-625-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15204 SPOTTED TURTLE CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935876",
            "telephone_number": "703-625-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTA",
        "first_name": "HARSH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "25MA10707600",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MD",
            "license": "D0073607",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "VA",
            "license": "0101242983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.