Active NPI
Suzanne Herten Wittig, MD
- Internal Medicine Physician
- MC Lean, VA
National Provider Identifier
1972658276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101224614
- Practice address
- 1750 Tysons Blvd Ste 1160
MC Lean, VA 22102-4230 - Phone
- (571) 341-9450
- Fax
- (571) 341-9453
- NPI assigned
- Jan 24, 2007
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101224614 | VA | Primary |
Addresses
Primary practice location
1750 Tysons Blvd Ste 1160
MC Lean, VA 22102-4230
Mailing address
1750 Tysons Blvd Ste 1160
MC Lean, VA 22102-4230
Phone (571) 341-9450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972658276 | Medicaid | VA |
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
- Opted out of Medicare
- Previously, effective Aug 8, 2018 through Aug 8, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101224614 | VA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- suzanne.wittig.1@28513.direct.athenahealth.com
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 and National Provider Directory roles.
-
- 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": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1972658276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 TYSONS BLVD STE 1160",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221024230",
"telephone_number": "571-341-9450",
"fax_number": "571-341-9453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 TYSONS BLVD STE 1160",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221024230",
"telephone_number": "571-341-9450",
"fax_number": "571-341-9453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTIG",
"first_name": "SUZANNE",
"middle_name": "HERTEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101224614",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1972658276",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.