Individual provider Active NPI

Bharath Dwaraka Nath, MD PHD

  • Pediatric Surgery Physician
  • Fairfax, VA
National Provider Identifier
1811275407
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
0101265162 Issued in VA
Practice address
8260 Willow Oaks Corporate Dr Ste 400
Fairfax, VA 22031-4513
Phone
(703) 560-2236
Fax
(571) 665-6834
NPI assigned
Jul 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101265162 VA
Pediatric Surgery Physician 2086S0120X 0101265162 VA Primary

Addresses

Primary practice location

8260 Willow Oaks Corporate Dr Ste 400
Fairfax, VA 22031-4513

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

2730 Prosperity Ave Ste C
Fairfax, VA 22031
Phone (703) 560-2236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20220606001800 DC Practitioner - Pediatric MedicinePractitioner - General Surgery 2860870771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101265162VAMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince May 16, 2022 Accepting new patients
Inova Health Care Services CurrentSince May 16, 2022 Accepting new patients

Locations

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

8260 Willow Oaks Corporate Dr
Ste 400
Fairfax, VA 22031
Phone (703) 560-2236

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

2730 Prosperity Ave
Ste C
Fairfax, VA 22031
Phone (703) 226-2280

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Interoperability endpoints

  • Direct secure messaging: bnath602188@soc.inova.org

Organizations & group practices 2

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": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1811275407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 WILLOW OAKS CORPORATE DR STE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314513",
            "telephone_number": "703-560-2236",
            "fax_number": "571-665-6834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 Prosperity Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "22031",
            "country_code": "US",
            "telephone_number": "703-560-2236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATH",
        "first_name": "BHARATH",
        "middle_name": "DWARAKA",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-29",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101265162",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "VA",
            "license": "0101265162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.