Individual provider Active NPI

Kumudini Attanagoda, MD

  • Psychiatry Physician
  • Washington, DC
National Provider Identifier
1891801460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD32845 Issued in DC
Practice address
4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone
(202) 885-5668
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD32845 DC Primary

Addresses

Primary practice location

4228 Wisconsin Ave NW
Washington, DC 20016-2138

Mailing address

1643 White Pine Dr
Vienna, VA 22182-1964
Phone (202) 885-5668

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
I20040726001375 DC Practitioner - Psychiatry 8123098464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Director of Finance-County of Fairfax VAGroup PAC ID 9739136847, 176 clinicians

Practice addresses (Care Compare)

14150 Parkeast Cir
Suite 200
Chantilly, VA 20151-4212
Phone (703) 324-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD32845DCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
D.C. Department of Behavioral Health PastSince May 29, 2022 Accepting new patients
Psychotherapeutic Rehabilation Services Psychiatry Past Accepting new patients

Organizations & group practices 4

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891801460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 WHITE PINE DR",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221821964",
            "telephone_number": "202-885-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "202-885-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTANAGODA",
        "first_name": "KUMUDINI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD32845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.