Organization Active NPI

Robert M. Gorsen M.D.,PHD.,P.C.

  • Neurological Surgery Physician
  • Annandale, VA
National Provider Identifier
1922025741
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
0101042525 Issued in VA
Legal business name
ROBERT M. GORSEN M.D.,PHD.,P.C.
Practice address
3301 Woodburn Rd
Suite 211
Annandale, VA 22003-1229
Phone
(703) 573-4700
Fax
(703) 573-7922
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Authorized official

Name
Dr. Robert M Gorsen, MDNPI 1285851303
Title
Owner
Phone
(703) 573-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 0101042525 VA Primary

Addresses

Primary practice location

3301 Woodburn Rd
Suite 211
Annandale, VA 22003-1229

Mailing address

3301 Woodburn Rd
Suite 211
Annandale, VA 22003-1229
Phone (703) 573-4700

Other identifiers 3

IdentifierTypeStateIssuer
096463OtherVAANTHEM
18110001OtherVABLUE CHOICE
4353845OtherVAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930098785 VA DME Supplier - Physician - Neurosurgery 6103026802 Practice locations: Annandale, VA
O20120926000222 DC Part B Supplier - Clinic/Group Practice 6103026802 Receives reassigned benefits from 1 practitioner
Practice locations: Annandale, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1922025741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN RD",
            "address_2": "SUITE 211",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031229",
            "telephone_number": "703-573-4700",
            "fax_number": "703-573-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN RD",
            "address_2": "SUITE 211",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031229",
            "telephone_number": "703-573-4700",
            "fax_number": "703-573-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT M. GORSEN M.D.,PHD.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "GORSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-573-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101042525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "096463",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "18110001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4353845",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.