Individual provider Active NPI

Sunil Amrit Kapoor, M.D.

  • Pediatric Pulmonology Physician
  • Fairfax, VA
National Provider Identifier
1801852215
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
0101231032 Issued in VA
Practice address
2730 A Prosperity Avenue
Fairfax, VA 22031-2238
Phone
(703) 289-1410
Fax
(703) 289-1420
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 0101231032 VA Primary
Pediatric Pulmonology Physician 2080P0214X MD21982 DC
Pediatric Pulmonology Physician 2080P0214X D0060870 MD

Addresses

Primary practice location

2730 A Prosperity Avenue
Fairfax, VA 22031-2238

Mailing address

2730 B Prosperity Avenue
Fairfax, VA 22031-2238
Phone (703) 289-1400

Other identifiers 4

IdentifierTypeStateIssuer
6716288MedicaidVA
6728094MedicaidVA
6716237MedicaidVA
6706703MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210917000080 GA Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 1850798836 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Pulmonary Disease
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21982DCMDPediatric Pulmonology Physician
D0060870MDMDPediatric Pulmonology Physician
0101231032VAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Sep 1, 2021 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Au Medical Associates Inc CurrentSince Sep 1, 2021 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients
Fairfax Neonatal Associates, PC Pediatric Pulmonology Past Accepting new patients

Locations

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 6

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1801852215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 B PROSPERITY AVENUE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312238",
            "telephone_number": "703-289-1400",
            "fax_number": "703-289-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 A PROSPERITY AVENUE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312238",
            "telephone_number": "703-289-1410",
            "fax_number": "703-289-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPOOR",
        "first_name": "SUNIL",
        "middle_name": "AMRIT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "VA",
            "license": "0101231032",
            "primary": true
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "DC",
            "license": "MD21982",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MD",
            "license": "D0060870",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6716288",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6728094",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6716237",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6706703",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.