Individual provider Active NPI

Gauri Raizada, P.A.

  • Physician Assistant
  • Lansdowne, VA
National Provider Identifier
1851625875
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110004887 Issued in VA
Practice address
19490 Sandridge Way Ste 210
Lansdowne, VA 20176-3467
Phone
(571) 223-5723
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110004887 VA Primary

Addresses

Primary practice location

19490 Sandridge Way Ste 210
Lansdowne, VA 20176-3467

Mailing address

19490 Sandridge Way Ste 210
Lansdowne, VA 20176-3467

Other identifiers 1

IdentifierTypeStateIssuer
1851625875MedicaidMI

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160415000086 VA Practitioner - Physician Assistant 8820135999 Reassigns benefits to 3 organizations
I20160425001182 DC Practitioner - Physician Assistant 8820135999 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fair Oaks Hospitalist Physicians, PLLCGroup PAC ID 1052419868, 63 clinicians

Practice addresses (Care Compare)

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3558

Hospital & facility affiliations

  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Mar 22, 2016 Accepting new patients
Loudoun Medical Group, PC CurrentSince Aug 19, 2017 Accepting new patients
Loudoun Medical Group, PC CurrentSince Aug 19, 2017 Accepting new patients
Privia Medical Group, LLC CurrentSince Mar 22, 2016 Accepting new patients

Locations

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

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

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

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

19490 Sandridge Way
Ste 210
Leesburg, VA 20176
Phone (703) 723-7504

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

8644 Sudley Rd
#220
Manassas, VA 20110

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 1

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": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1851625875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19490 SANDRIDGE WAY STE 210",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201763467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19490 SANDRIDGE WAY STE 210",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201763467",
            "telephone_number": "571-223-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIZADA",
        "first_name": "GAURI",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851625875",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdowne, VA

Sources for this page

Verify at the official NPI Registry.