Individual provider Active NPI

Renata A Nowak, MD

  • Internal Medicine Physician
  • Fairfax, VA
National Provider Identifier
1922031293
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101255686 Issued in VA
Practice address
10580 Arrowhead Dr
Fairfax, VA 22030-7301
Phone
(571) 432-2600
Fax
(571) 432-2787
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01012 VA
Internal Medicine Physician 207R00000X 30440 TN
Internal Medicine Physician 207R00000X 0101255686 VA Primary

Addresses

Primary practice location

10580 Arrowhead Dr
Fairfax, VA 22030-7301

Mailing address

4375 Fair Lakes CT
Fairfax, VA 22033-4234
Phone (571) 432-2600

Other identifiers 1

IdentifierTypeStateIssuer
3730302MedicaidTN

Other names 1

  • Dr. Renata A Drabik-Nowak Other name

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
I20190404000009 DC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6204872484

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30440TNMDInternal Medicine Physician
01012VAMDInternal Medicine Physician
0101255686VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Specialty Clinic, PLLC Past Accepting new patients
Dr Arun K Gupta PC PastSince Jul 9, 2025 Accepting new patients

Organizations & group practices 2

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1922031293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 FAIR LAKES CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334234",
            "telephone_number": "571-432-2600",
            "fax_number": "571-432-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10580 ARROWHEAD DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307301",
            "telephone_number": "571-432-2600",
            "fax_number": "571-432-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "RENATA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "01012",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "30440",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101255686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3730302",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENATA",
            "last_name": "DRABIK-NOWAK",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.