Individual provider Active NPI

Balraj Dhillon, MD

  • Psychiatry Physician
  • Manassas, VA
National Provider Identifier
1780677989
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101236602 Issued in VA
Practice address
8680 Hospital Way
Manassas, VA 20110-4287
Phone
(703) 369-8464
Fax
(703) 369-8467
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101236602 VA Primary

Addresses

Primary practice location

8680 Hospital Way
Manassas, VA 20110-4287

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (703) 369-8464

Other identifiers 1

IdentifierTypeStateIssuer
1780677989MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20041028001064 VA Practitioner - Psychiatry 4385606649
I20051109000532 DC Practitioner - Psychiatry 4385606649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13505 Dulles Technology Dr
Suite 1a
Herndon, VA 20171-3403
Phone (703) 773-0447

19415 Deerfield Ave
Suite 310
Lansdowne, VA 20176-8472
Phone (703) 773-0447

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101236602VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Virginia Psychiatry PC Psychiatry CurrentSince Aug 26, 2005 Accepting new patients

Locations

12475 Route 50
Fairfax, VA 22033
Phone (703) 352-7172

13505 Dulles Technology Dr
Ste 1A
Herndon, VA 20171
Phone (703) 404-5900

19415 Deerfield Ave
Ste 115
Leesburg, VA 20176
Phone (703) 729-2626

19415 Deerfield Ave
Ste 310
Leesburg, VA 20176
Phone (703) 726-6393

170 W Shirley Ave
Ste 208
Warrenton, VA 20186
Phone (703) 773-0447

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1780677989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "703-369-8464",
            "fax_number": "703-369-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8680 HOSPITAL WAY",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104287",
            "telephone_number": "703-369-8464",
            "fax_number": "703-369-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHILLON",
        "first_name": "BALRAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101236602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780677989",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.