Individual provider Active NPI

Michael Joseph Eblan, MD

  • Radiation Oncology Physician
  • Fairfax, VA
National Provider Identifier
1962795773
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
0101260437 Issued in VA
Practice address
8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone
(571) 472-0606
Fax
(571) 472-0540
NPI assigned
May 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 0101260437 VA Primary

Addresses

Primary practice location

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Mailing address

9568 Kings Charter Dr Ste 202
Ashland, VA 23005-7955
Phone (804) 266-8717

Other identifiers 1

IdentifierTypeStateIssuer
1962795773MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20161003000013 DC Practitioner - Radiation Oncology 0345464590 Reassigns benefits to 1 organization
I20161031001547 VA Practitioner - Radiation Oncology 0345464590 Reassigns benefits to 1 organization
I20170227002016 MD Practitioner - Radiation Oncology 0345464590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Perelman School of Med at the University of Pennsylvania, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Radiation Oncology Associates PCGroup PAC ID 1254302359, 22 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-3731

44035 Riverside Pkwy
Suite 100
Leesburg, VA 20176-8274
Phone (703) 858-8850

Hospital & facility affiliations

  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043
  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101

Merit-based Incentive Payment System (MIPS)

Final score
80.82 of 100Reported as group
Quality
76.08
Promoting interoperability
100
Improvement activities
40
Cost
59.98

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Radiation Oncology Associates PA Radiation Oncology CurrentSince Feb 5, 2017 Accepting new patients
Radiation Oncology Associates, PC Radiation Oncology CurrentSince Oct 1, 2016 Accepting new patients
Maryland Proton Treatment Center, LLC CurrentSince Feb 5, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

850 W Baltimore St
Baltimore, MD 21201
Phone (410) 227-7434

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

9568 Kings Charter Dr
Ste 202
Ashland, VA 23005
Phone (804) 266-8717

3580 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-4250

8081 Innovation Park Dr
Fairfax, VA 22031
Phone (571) 472-0606

8081 Innovation Park Dr
Ste 301
Fairfax, VA 22031
Phone (571) 472-6431

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

44035 Riverside Pkwy
Ste 100
Leesburg, VA 20176
Phone (703) 858-8850

2280 Opitz Blvd
Ste 120
Woodbridge, VA 22191
Phone (703) 580-5160

Interoperability endpoints

  • Direct secure messaging: meblan479983@direct.umm.edu

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.

Hospital & facility affiliations 6

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": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1962795773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9568 KINGS CHARTER DR STE 202",
            "city": "ASHLAND",
            "state": "VA",
            "postal_code": "230057955",
            "telephone_number": "804-266-8717",
            "fax_number": "804-266-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-0606",
            "fax_number": "571-472-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBLAN",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-26",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VA",
            "license": "0101260437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962795773",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.