Individual provider Active NPI

Trevor Michio Uyemura

  • Infectious Disease Physician
  • Fairfax, VA
National Provider Identifier
1942599634
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
0101259708 Issued in VA
Practice address
11211 Waples Mill Rd
Ste 200
Fairfax, VA 22030-7406
Phone
(703) 246-9560
Fax
(703) 246-9564
NPI assigned
Apr 1, 2011
Last updated
Aug 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 0101259708 VA Primary

Addresses

Primary practice location

11211 Waples Mill Rd
Ste 200
Fairfax, VA 22030-7406

Mailing address

11211 Waples Mill Rd
Suite 200
Fairfax, VA 22030-7406
Phone (703) 246-9560

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
I20160506000902 DC Practitioner - Infectious Disease 0244539633 Reassigns benefits to 1 organization
I20171204000782 VA Practitioner - Infectious Disease 0244539633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
University of Miami, LM Miller School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infectious Disease ConsultantsGroup PAC ID 2466550090, 10 clinicians

Practice addresses (Care Compare)

11211 Waples Mill Rd
Suite 200
Fairfax, VA 22030-7406
Phone (703) 246-9560

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 246-9560

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101259708VAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Disease Consultants Infectious Disease CurrentSince Jul 1, 2016 Accepting new patients

Locations

11211 Waples Mill Rd
Ste 200
Fairfax, VA 22030
Phone (703) 246-9560

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

Interoperability endpoints

  • Direct secure messaging: tuyemura28471@soc.inova.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1942599634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 WAPLES MILL RD",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307406",
            "telephone_number": "703-246-9560",
            "fax_number": "703-246-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 WAPLES MILL RD",
            "address_2": "STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307406",
            "telephone_number": "703-246-9560",
            "fax_number": "703-246-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UYEMURA",
        "first_name": "TREVOR",
        "middle_name": "MICHIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0101259708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.