Individual provider Active NPI

Sandra I Tandeciarz, MD

  • Family Medicine Physician
  • Vienna, VA
National Provider Identifier
1811981129
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101052988 Issued in VA
Practice address
115 Park St SE
Suite 300
Vienna, VA 22180-4653
Phone
(703) 255-9100
Fax
(703) 255-3457
NPI assigned
Sep 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101052988 VA Primary

Addresses

Primary practice location

115 Park St SE
Suite 300
Vienna, VA 22180-4653

Mailing address

115 Park St SE
Suite 300
Vienna, VA 22180-4653
Phone (703) 255-9100

Other identifiers 1

IdentifierTypeStateIssuer
05645913MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address standeciarz26310@soc.inova.org Health Information Exchange (HIE) Inova Physician Partners, LLC

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
I20050429000605 DC Practitioner - Family Practice 0547209447 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairfax Family Practice Centers PCGroup PAC ID 4082513031, 106 clinicians

Practice addresses (Care Compare)

115 Park St SE
Suite 300
Vienna, VA 22180-4653
Phone (703) 255-9100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101052988VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Family Medicine CurrentSince Jun 24, 2015 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 24, 2015 Accepting new patients
Inova Physician Partners, LLC Family Medicine CurrentSince Jun 25, 2020 Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

6201 Centreville Rd
Ste 100
Centreville, VA 20121
Phone (703) 263-9600

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

115 Park St SE
Ste 205
Vienna, VA 22180
Phone (703) 255-9100

115 Park St SE
Ste 300
Vienna, VA 22180
Phone (703) 255-9100

Interoperability endpoints

  • Direct secure messaging: standeciarz26310@soc.inova.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1811981129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PARK ST SE",
            "address_2": "SUITE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804653",
            "telephone_number": "703-255-9100",
            "fax_number": "703-255-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PARK ST SE",
            "address_2": "SUITE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804653",
            "telephone_number": "703-255-9100",
            "fax_number": "703-255-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDECIARZ",
        "first_name": "SANDRA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101052988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05645913",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "standeciarz26310@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "115 Park St SE",
            "address_2": "Suite 300",
            "city": "Vienna",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221804653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.