Jyoti Harsh Supanekar, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

010238493 Issued in VA

Practice address

15941 Donald Curtis Dr
Suite 200
Woodbridge, VA 22191-4256

Phone

(703) 792-4900

Fax

(703) 792-7057

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Psychiatry

Education

Eastern Virginia Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Director of Finance-County of Fairfax VAGroup PAC ID 9739136847, 176 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Fairfax County, Virginia

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfax, VA
  • NPI 1154356244

  DC

  Medicare reassignment Care Compare group
• Prince William County Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manassas, VA
  • NPI 1053402800
  Medicare reassignment NPD
• Prince William County

  • Ambulance
  • Prince William, VA
  • NPI 1235437385
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Fairfax, VA
  • NPI 1588785620
  NPD (past)
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1902943483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7969 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092885",
            "telephone_number": "703-792-7800",
            "fax_number": "703-792-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15941 DONALD CURTIS DR",
            "address_2": "SUITE 200",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914256",
            "telephone_number": "703-792-4900",
            "fax_number": "703-792-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPANEKAR",
        "first_name": "JYOTI",
        "middle_name": "HARSH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "010238493",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD035927",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Sunia, DO
• Sunny Days Behavior Change
• Sunnycreditrepair
• Sunrise Counseling Services, PLLC
• Sunrise Homecare, LLC
• Superior Care & Support, LLC
• Peter Suppa
• Angela Mary Suraci, BCBA
• Lillian Sutherlin, DPT
• Elena Igorevna Sutphin, PTA

• Psychiatry Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.