NPIMap

Organization Active NPI

Sleep Disorders CTRS of the Mid Atlantic LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Fairfax, VA
National Provider Identifier
1770753469
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC
Practice address
10875 Main St
Suite 212
Fairfax, VA 22030-4732
Phone
(703) 877-2087
Fax
(703) 934-6690
NPI assigned
Mar 10, 2008
Last updated
Oct 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Authorized official

Name
James R Perlstrom, PHDNPI 1760575765
Title
President
Phone
(703) 752-7881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X VA Primary
Durable Medical Equipment & Medical Supplies 332B00000X VA

Addresses

Primary practice location

10875 Main St
Suite 212
Fairfax, VA 22030-4732

Mailing address

2235 Cedar LN
Suite 202
Vienna, VA 22182-5202
Phone (703) 752-7881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526001149 DC Part B Supplier - Clinic/Group Practice 2264413137 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
Practice locations: Rockville, MD; Vienna, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sleep Disorders CTRS of the Mid Atlantic LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1770753469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 CEDAR LN",
            "address_2": "SUITE 202",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221825202",
            "telephone_number": "703-752-7881",
            "fax_number": "703-752-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10875 MAIN ST",
            "address_2": "SUITE 212",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304732",
            "telephone_number": "703-877-2087",
            "fax_number": "703-934-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP DISORDERS CTRS OF THE MID ATLANTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "PERLSTROM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-752-7881",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.