Mark J Tedesco, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD043004E Issued in PA

Practice address

3990 Fettler Park Dr
Suite B
Dumfries, VA 22025-1997

Phone

(703) 680-3489

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Virginia Urgent Care LLC

  • Urgent Care Clinic/Center
  • Fredericksburg, VA
  • NPI 1487838652
  Medicare reassignment NPD

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1689695280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5089 WILLOW OAK PL",
            "city": "MONTCLAIR",
            "state": "VA",
            "postal_code": "220253010",
            "telephone_number": "703-680-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 FETTLER PARK DR",
            "address_2": "SUITE B",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251997",
            "telephone_number": "703-680-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESCO",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD043004E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunseeds Counseling, LLC
• Sunshine Quality Healthcare, LLC
• Target Pharmacy
• Amy Bartlett Taylor, LCSW, MSW
• Brandi Taylor
• Sheila A Tetreault, DO
• Nana Agyeiwaa Tetteh, FNP-BC
• Payal Thakkar, PT, DPT
• The Devana Group LLC
• Ratcliff Thomas

• Family Medicine Physician in Dumfries, VA
• Providers in Dumfries, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.