Active NPI
Mirja Laroche, MD
- Anesthesiology Physician
- Fairfax, VA
National Provider Identifier
1780846113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 0101249195
- Practice address
- 3600 Joseph Siewick Dr
Anesthesia Dept
Fairfax, VA 22033-1709 - Phone
- (703) 391-3129
- Fax
- (703) 295-9369
- NPI assigned
- Jun 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 0101249195 | VA | Primary |
| Anesthesiology Physician | 207L00000X | 2774281 | NY |
Addresses
Primary practice location
3600 Joseph Siewick Dr
Anesthesia Dept
Fairfax, VA 22033-1709
Mailing address
68 S Service Rd
Suite 350
Melville, NY 11747
Phone (516) 945-3107
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 303887 | Other | VA | KAISER |
| 1780846113 | Medicaid | VA | |
| K142-0001 | Other | DC | CARE FIRST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2774281 | NY | MD | Anesthesiology Physician |
| 0101249195 | VA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459382400000",
"number": "1780846113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 S SERVICE RD",
"address_2": "SUITE 350",
"city": "MELVILLE",
"state": "NY",
"postal_code": "11747",
"telephone_number": "516-945-3107",
"fax_number": "516-945-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 JOSEPH SIEWICK DR",
"address_2": "ANESTHESIA DEPT",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220331709",
"telephone_number": "703-391-3129",
"fax_number": "703-295-9369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAROCHE",
"first_name": "MIRJA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-26",
"last_updated": "2016-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VA",
"license": "0101249195",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "2774281",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "303887",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1780846113",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST",
"identifier": "K142-0001",
"state": "DC"
}
],
"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 Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.