Active NPI
Sydney Beache, MD
- Colon & Rectal Surgery Physician
- Fairfax, VA
National Provider Identifier
1962997825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- 0101290498
- Practice address
- 2710 Prosperity Ave Ste 200
Fairfax, VA 22031-4358 - Phone
- (443) 717-0961
- NPI assigned
- Jun 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | 0101290498 | VA | Primary |
Addresses
Primary practice location
2710 Prosperity Ave Ste 200
Fairfax, VA 22031-4358
Mailing address
2710 Prosperity Ave Ste 200
Fairfax, VA 22031-4358
Phone (443) 717-0961
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018021351 | MO | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1962997825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2710 PROSPERITY AVE STE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314358",
"telephone_number": "443-717-0961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 PROSPERITY AVE STE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314358",
"telephone_number": "443-717-0961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEACHE",
"first_name": "SYDNEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-24",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "VA",
"license": "0101290498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.