Organization Active NPI

Nephrology & Hypertension of Virginia,PLLC

  • Nephrology Physician
  • Reston, VA
National Provider Identifier
1780161687
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY & HYPERTENSION OF VIRGINIA,PLLC
Practice address
1897 Preston White Dr Ste 105
Reston, VA 20191-5475
Phone
(703) 468-1270
NPI assigned
Jul 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Authorized official

Name
Neeraja TandraNPI 1821201385
Title
Provider/Owner
Phone
(703) 468-1270

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1897 Preston White Dr Ste 105
Reston, VA 20191-5475

Mailing address

PO Box 23809
Belfast, ME 04915-4489

Other practice location 1

19415 Deerfield Ave Ste 103
Leesburg, VA 20176-8470
Phone (703) 468-1270

Other identifiers 1

IdentifierTypeStateIssuer
1821201385MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181214000218 DC Part B Supplier - Clinic/Group Practice 8921343229 Receives reassigned benefits from 1 practitioner
Practice locations: Reston, VA
O20190227001372 VA Part B Supplier - Clinic/Group Practice 8921343229 Receives reassigned benefits from 1 practitioner
Practice locations: Lansdowne, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1780161687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23809",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1897 PRESTON WHITE DR STE 105",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201915475",
            "telephone_number": "703-468-1270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19415 Deerfield Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201768470",
            "country_code": "US",
            "telephone_number": "703-468-1270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEPHROLOGY & HYPERTENSION OF VIRGINIA,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "TANDRA",
        "authorized_official_first_name": "NEERAJA",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "703-468-1270"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821201385",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.