Individual provider Active NPI

Grace Cruz Banez Sese, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Falls Church, VA
National Provider Identifier
1972770683
Registry record updated Jan 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0101243543 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-1110
NPI assigned
May 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101243543 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

PO Box 221322
Chantilly, VA 20153-1322
Phone (703) 691-1494

Other identifiers 2

IdentifierTypeStateIssuer
1972770683OtherHIGHMARK MEDICARE
1972770683MedicaidVA

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
I20081008000414 DC Practitioner - Pathology 8123196839 Reassigns benefits to 3 organizations
I20140513001038 VA Practitioner - Pathology 8123196839 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care Services - PathologyGroup PAC ID 8426241647, 46 clinicians

Practice addresses (Care Compare)

3023 Hamaker CT
Suite 400
Fairfax, VA 22031-2247
Phone (571) 226-8380

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jan 1, 2015 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2015 Accepting new patients
Inova Health Care Services CurrentSince Feb 21, 2015 Accepting new patients
Inova Health Care Services - Pathology Anatomic Pathology & Clinical Pathology CurrentSince Sep 4, 2010 Accepting new patients
Fairfax Pathology Associates LTD Anatomic Pathology & Clinical Pathology Past Accepting new patients
Fairfax Pathology Associates, LTD. Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

3289 Woodburn Rd
Ste 10
Annandale, VA 22003
Phone (866) 256-6372

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

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

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

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

45745 Nokes Blvd
Ste 160
Sterling, VA 20166
Phone (866) 256-6372

Interoperability endpoints

  • Direct secure messaging: gbanezsese28744@soc.inova.org

Organizations & group practices 6

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 2

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": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232755200000",
    "number": "1972770683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221322",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201531322",
            "telephone_number": "703-691-1494",
            "fax_number": "703-691-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANEZ SESE",
        "first_name": "GRACE",
        "middle_name": "CRUZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2009-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101243543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK MEDICARE",
            "identifier": "1972770683",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972770683",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.