Individual provider Active NPI

Shivam A Champaneri, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Alexandria, VA
National Provider Identifier
1932321981
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0101253867 Issued in VA
Practice address
6354 Walker LN Ste 400
Alexandria, VA 22310-3252
Phone
(571) 472-7322
Fax
(571) 472-7323
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 0101253867 VA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X D0072073 MD
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0101253867 VA Primary

Addresses

Primary practice location

6354 Walker LN Ste 400
Alexandria, VA 22310-3252

Mailing address

6354 Walker LN Ste 400
Alexandria, VA 22310-3252
Phone (571) 472-7322

Other identifiers 1

IdentifierTypeStateIssuer
043171100MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schampaneri99191@soc.inova.org Health Information Exchange (HIE) Inova Health Care Services

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
I20130820000140 DC Practitioner - Internal MedicinePractitioner - Endocrinology 9436337912 Reassigns benefits to 1 organization
I20160503002079 VA Practitioner - Internal MedicinePractitioner - Endocrinology 9436337912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101253867VAMDInternal Medicine Physician
D0072073MDMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jan 1, 2016 Accepting new patients
Inova Health Care Services Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Inova Health Care Services CurrentSince Feb 14, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6354 Walker Ln
Ste 400
Alexandria, VA 22310
Phone (571) 472-7320

6355 Walker Ln
Ste 405
Alexandria, VA 22310
Phone (703) 719-6715

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

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

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

224D Cornwall St NW
Leesburg, VA 20176
Phone (571) 291-3458

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 4

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1932321981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6354 WALKER LN STE 400",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103252",
            "telephone_number": "571-472-7322",
            "fax_number": "571-472-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6354 WALKER LN STE 400",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103252",
            "telephone_number": "571-472-7322",
            "fax_number": "571-472-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPANERI",
        "first_name": "SHIVAM",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101253867",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "D0072073",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101253867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043171100",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schampaneri99191@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "6355 Walker Ln",
            "address_2": "Suite 405",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223103245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.