Active NPI
Romaldo Desouza, M.D.
- Pulmonary Disease Physician
- Gainesville, VA
National Provider Identifier
1710953294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 0101128303
- Practice address
- 6344 Tred Avon Place
Gainesville, VA 20155 - Phone
- (703) 217-6255
- NPI assigned
- Feb 24, 2006
- Last updated
- May 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 0101128303 | VA | Primary |
Addresses
Primary practice location
6344 Tred Avon Place
Gainesville, VA 20155
Mailing address
12032 Winding Creek CT
Clifton, VA 20124-2242
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017717400 | Medicaid | DC | |
| 0006 | Other | DC | CAREFIRST BC OF NCA NUMBE |
| 211234 | Other | VA | TRIGON BC NUMBER |
| 559930001 | Medicaid | MD | |
| 005824184 | Medicaid | VA | |
| 53309413 | Other | MD | CAREFIRST BC NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101128303 | VA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Romaldo Desouza, MD | Current | Accepting new patients | |
| Inova Health Care Services | Current | Accepting new patients | |
| Inova Health Care Services | Current | Accepting new patients |
Locations
3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395
224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1710953294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12032 WINDING CREEK CT",
"city": "CLIFTON",
"state": "VA",
"postal_code": "201242242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6344 TRED AVON PLACE",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "20155",
"telephone_number": "703-217-6255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESOUZA",
"first_name": "ROMALDO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "VA",
"license": "0101128303",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "017717400",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BC OF NCA NUMBE",
"identifier": "0006",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIGON BC NUMBER",
"identifier": "211234",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "559930001",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005824184",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BC NUMBER",
"identifier": "53309413",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.