Individual provider Active NPI

Pankaj Nepal

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1902327562
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
290736 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 724-0288
NPI assigned
Jul 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 290736 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

1966 1St Ave Apt 4N
New York, NY 10029-6465
Phone (215) 584-3245

Other practice location 1

1901 1st Ave
New York, NY 10029-7404
Phone (212) 423-6771

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230818000157 VA Practitioner - Diagnostic Radiology 6608257779 Reassigns benefits to 2 organizations
I20230901002631 DC Practitioner - Diagnostic Radiology 6608257779 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ifrc LLCGroup PAC ID 2961829882, 135 clinicians
Fairfax Radiological ConsultantsGroup PAC ID 8628970324, 151 clinicians
Inova Reston MRI Center LLCGroup PAC ID 2961540042, 101 clinicians

Practice addresses (Care Compare)

19455 Deerfield Ave
Suite 102
Leesburg, VA 20176-8102
Phone (703) 698-4488

3299 Woodburn Rd
Suite 110
Annandale, VA 22003-7310
Phone (703) 698-4488

4 Pidgeon Hill Dr
Sterling, VA 20165-6173
Phone (703) 698-4488

4001 Prince William Pkwy
Suite 302
Woodbridge, VA 22192-7667
Phone (703) 698-4444

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6470

8081 Innovation Park Dr
Suite 204
Fairfax, VA 22031-4867
Phone (703) 698-9600

8505 Arlington Blvd
Suite 400
Fairfax, VA 22031-4636
Phone (703) 698-4484

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Reston MRI Center LLC Diagnostic Radiology CurrentSince Aug 1, 2023 Accepting new patients
Inova Health Care Services CurrentSince Aug 1, 2023 Accepting new patients
Inova Reston MRI Center LLC CurrentSince Aug 1, 2023 Accepting new patients
Ifrc, LLC CurrentSince Aug 1, 2023 Accepting new patients
Fairfax Radiological Consultants Diagnostic Radiology CurrentSince Aug 1, 2023 Accepting new patients

Locations

8926 Woodyard Rd
Ste 301
Clinton, MD 20735
Phone (301) 856-3670

3299 Woodburn Rd
Ste 110
Annandale, VA 22003
Phone (703) 849-9050

43490 Yukon Dr
Ste 204
Ashburn, VA 20147
Phone (571) 665-6960

8505 Arlington Blvd
Ste 400
Fairfax, VA 22031
Phone (571) 226-5600

8081 Innovation Park Dr
Ste 204
Fairfax, VA 22031
Phone (703) 698-9600

8260 Willow Oaks Corporate Dr
Ste 750
Fairfax, VA 22031
Phone (703) 481-9400

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

100 Elden St
Ste 16M
Herndon, VA 20170
Phone (703) 481-9400

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

19455 Deerfield Ave
Ste 102
Leesburg, VA 20176
Phone (703) 858-0001

Interoperability endpoints

  • Direct secure messaging: pankaj.nepal@xdr.hhchealthdirect.org

Organizations & group practices 5

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 7

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1902327562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1966 1ST AVE APT 4N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296465",
            "telephone_number": "215-584-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-0288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100297404",
            "country_code": "US",
            "telephone_number": "212-423-6771",
            "fax_number": "212-423-6771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEPAL",
        "first_name": "PANKAJ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "290736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.