Harika Guduru
Individual provider Active NPI Internal Medicine Physician · Aldie, VA
NPI 1972066769 · NPPES record last updated Oct 13, 2022
Key facts
- NPI
- 1972066769
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 0101276857 (VA)
- Practice address
- 24560 Southpoint Dr Ste 220
Aldie, VA 20105-3505 - Phone
- (571) 570-4300
- NPI assigned
- Apr 9, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Privia Medical Group, LLC
Practice addresses (Care Compare)
24560 Southpoint Dr
Suite 220
Aldie, VA 20105-3505
Phone (571) 570-4300
8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845
Hospital & facility affiliations
- Reston Hospital Center
- Stonesprings Hospital Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221128000840 | VA | Practitioner - Internal Medicine | 9830567726 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group, LLC | Current |
Accepting new patients | |
| Privia Medical Group, LLC | Internal Medicine | Current |
Accepting new patients |
| Nova Physician Wellness Center PLLC | Past | Accepting new patients |
Locations
24560 Southpoint Dr
Ste 220
Aldie, VA 20105
Phone (315) 601-0174
24560 Southpoint Dr
Ste 200
Aldie, VA 20105
Phone (315) 601-0174
950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065
8644 Sudley Rd
#220
Manassas, VA 20110
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
- harika.guduru.1@8042.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101276857 | VA | Yes |
Addresses
Primary practice location
24560 Southpoint Dr Ste 220
Aldie, VA 20105-3505
Mailing address
22411 Claude Moore Dr
Ashburn, VA 20148-3206
Phone (513) 678-4806
Other providers in Aldie, VA
- Javiela Francisca Galvez
- Alan Arthur Goldblatt
- Lerah Gordon
- Shelley Green
- Belinda A Griffin
- Almira A. Haque
- Harris Teeter, LLC
- Corrine Haselden
- Healing Hearts VA, LLC
- Marika Heinicke
All providers in Aldie, VA · Internal Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.