Kahlil Ashley Gaiters, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102207285 Issued in VA

Practice address

10945 George Mason Cir Ste 105
Manassas, VA 20110-2233

Phone

(703) 361-5116

Fax

(571) 364-8911

NPI assigned

Jul 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Family Practice

Education

West Virginia School of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Lansdowne, VA
  • NPI 1861552721

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Uva Community Health Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Charlottesville, VA
  • NPI 1598475741
  Medicare reassignment NPD
• Uva Community Health Medical Group, LLC

  • Emergency Medicine Physician
  • Bristow, VA
  • NPI 1972978195
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1982257960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936952",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 GEORGE MASON CIR STE 105",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201102233",
            "telephone_number": "703-361-5116",
            "fax_number": "571-364-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAITERS",
        "first_name": "KAHLIL",
        "middle_name": "ASHLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-19",
        "last_updated": "2023-01-27",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116033462",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102207285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10945 George Mason Cir Ste 105",
            "city": "Manassas",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201102233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Futures ABA VA LLC
• Gabriel Gluck MD PC
• Stephanie Gabrys, MSN, AGACNP-BC
• Claudette Gadson
• Myeisha Gage, M.ED.,BT
• Hema R Gajula, M.D.
• Galaxy Behavioral Health
• Cathryn Therese Gallagher
• Joni Gallegos, PT
• Galleria Family Dentistry

• Family Medicine Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.