KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. (NPI# 1215058326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215058326 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. |
| Other Organization Name | FAIR OAKS MEDICAL CENTER |
| Practice Address |
12255 Fair Oaks Pkwy Fairfax VA 22033-3952 |
| Mailing Address |
2101 E Jefferson St Rockville MD 20852-4908 |
| Practice Telephone | 7039345700 |
| Practice Fax Number | 7039345745 |
| Mailing Telephone | 3018167446 |
| Mailing Fax Number | 3018167170 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2014-06-27 |
| Authorized Official Name | DEANNE G PETERSEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3018165760 |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Fair Oaks Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316574833 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 4400 Forbes Blvd, Lanham, MD 20706-4447 | 2020-03-25 |
| 1285752121 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Health Maintenance Organization | 7670 Quarterfield Rd, Glen Burnie, MD 21061-3947 | 2007-03-27 |
| 1417075318 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Health Maintenance Organization | 7190 Crestwood Boulevard, Frederick, MD 21703-7314 | 2007-03-27 |
| 1699833202 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinical Medical Laboratory | 6625 Belcrest Highway, Hyattsville, MD 20782-2003 | 2006-12-05 |
| 1285272369 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 700 2nd St Ne, Washington, DC 20002-8100 | 2019-12-19 |
| 1457999542 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 4920 Campbell Blvd, Baltimore, MD 21236-5916 | 2019-12-19 |
| 1689212763 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 201 N Washington St, Falls Church, VA 22046-4518 | 2019-12-19 |
| 1659919744 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 6501 Loisdale Ct, Springfield, VA 22150-1826 | 2019-12-19 |
| 1710525803 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2019-12-19 |
| 1447898531 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 7141 Security Blvd, Baltimore, MD 21244-1811 | 2019-12-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 1 Kaiser Plz, Oakland, CA 94612-3610 |
| Street Address |
12255 FAIR OAKS PKWY |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-3952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528309606 | Portereshice Shunta Brabham | Health Maintenance Organization | 345 Amelia St, Fairfax, SC 29827-5967 | 2013-03-14 |
| 1760811855 | All Pro Dental Care | Health Maintenance Organization | 8500 Executive Park Ave, Suite 208, Fairfax, VA 22031-2225 | 2013-11-08 |
| 1588785620 | Kaiser Foundation Health Plan of The Mid-atlantic States Inc. | Health Maintenance Organization | 8550 Lee Hwy, Fairfax, VA 22031-1515 | 2007-04-03 |
| 1114048295 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Health Maintenance Organization | 12011 Lee Jackson Memorial Hwy, Fairfax, VA 22033-3310 | 2007-04-03 |
| 1821118373 | Kaiser Foundation Health of The Plan Mid-atlantic States,inc | Health Maintenance Organization | 8261 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265031629 | Suzanne Eva Leitner-wise | Health Maintenance Organization | 532 N Washington St Ste 100, Alexandria, VA 22314-2314 | 2020-10-18 |
| 1700371358 | Mgellan Complete Care Virginia | Health Maintenance Organization | 3829 Gaskins Rd, Richmond, VA 23233-1437 | 2018-06-26 |
| 1780102335 | Illuminated Direction | Health Maintenance Organization | 6116 Rolling Road Suite 104, Springfield, VA 22152 | 2017-09-05 |
| 1790228146 | Walgreens | Health Maintenance Organization | 99 Tide Mill Ln, Apt #96, Hampton, VA 23666-2764 | 2016-12-02 |
| 1457719205 | Heavenly Friends Home Healthcare Services LLC. | Health Maintenance Organization | 24 Palisade Pt, Hampton, VA 23666-6029 | 2016-02-08 |
| 1609240142 | Hearing Healthcare of Virginia | Health Maintenance Organization | 1951 Evelyn Byrd Ave Ste F, Harrisonburg, VA 22801-3483 | 2015-11-20 |
| 1558735332 | Meluzio Psychological Services, LLC | Health Maintenance Organization | 10 Indian Wood Ln, Fredericksburg, VA 22405-1834 | 2015-11-17 |
| 1730555780 | No Place Like Home | Health Maintenance Organization | 1713 Sunset Dr, Bassett, VA 24055-4834 | 2015-08-13 |
| 1073992434 | We Care Home Health Services | Health Maintenance Organization | 102 Pine View Street, Patrick Springs, VA 24133-3701 | 2015-05-19 |
| 1275911653 | Peace From Pieces | Health Maintenance Organization | 307 Lafayette Blvd Ste 202, Fredericksburg, VA 22401-6079 | 2015-05-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.