Individual provider Active NPI

Gayatri Vaddadi, MD

  • General Acute Care Hospital
  • Manassas, VA
National Provider Identifier
1902034655
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Practice address
6356 Hoadly Rd
Manassas, VA 20112-3422
Phone
(703) 590-5999
Fax
(703) 590-5399
NPI assigned
Jul 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 0101251908 VA
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

6356 Hoadly Rd
Manassas, VA 20112-3422

Mailing address

1101 Sam Perry Boulevard
Suite 207
Fredericksburg, VA 22401-4453
Phone (540) 741-3340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140219001618 DC Practitioner - Family PracticePractitioner - Emergency Medicine 5991935884 Reassigns benefits to 1 organization
I20140327000749 VA Practitioner - Family Practice 5991935884 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Providers LLCGroup PAC ID 1456629369, 264 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-4350

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101251908VAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Providers LLC CurrentSince May 1, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 10, 2018 Accepting new patients

Locations

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

10701 Rosemary Dr
Manassas, VA 20109
Phone (703) 257-3000

125 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 602-6500

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Interoperability endpoints

  • Direct secure messaging: gvaddadi54938@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 3

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": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1902034655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BOULEVARD",
            "address_2": "SUITE 207",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014453",
            "telephone_number": "540-741-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6356 HOADLY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123422",
            "telephone_number": "703-590-5999",
            "fax_number": "703-590-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADDADI",
        "first_name": "GAYATRI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "VA",
            "license": "0101251908",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.