Active NPI
Shivam A Champaneri, MD
- Endocrinology, Diabetes & Metabolism Physician
- Alexandria, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 0101253867
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043171100 | Medicaid | MD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 83.36 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0101253867 | VA | MD | Internal Medicine Physician |
| D0072073 | MD | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inova Health Care Services | Current | Accepting new patients | |
| Inova Health Care Services | Internal Medicine | Current | Accepting new patients |
| Inova Health Care Services | Current | 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.
-
- Multi-Specialty Clinic/Center
- Fairfax, VA
- NPI 1669511051
-
- Medical Technologist
- Sterling, VA
- NPI 1699655589
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.