POTOMAC EAR NOSE & THROAT PLLC (NPI# 1881726065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881726065 |
| Entity Type | Organization |
| Organization Name | POTOMAC EAR NOSE & THROAT PLLC |
| Practice Address |
2070 Old Bridge Road Suite 103 Woodbridge VA 22192 |
| Mailing Address |
Po Box 7657 Woodbridge VA 22195-7657 |
| Practice Telephone | 7034998787 |
| Practice Fax Number | 7034998222 |
| Mailing Telephone | 7034998787 |
| Mailing Fax Number | 7034998222 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2015-10-19 |
| Authorized Official Name | RAMIN IPAKCHI (PARTNER MD) |
| Authorized Official Telephone | 7034998787 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 0101236020 | VA | Allopathic & Osteopathic Physicians |
| Y | 207Y00000X | Otolaryngology | 0101234863 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1881726065 | 05 | |
| VA | RR MEDICARE | DD2998 | 01 |
| Street Address |
2070 OLD BRIDGE ROAD SUITE 103 |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700943990 | Juan Ramon Hernandez | Otolaryngology | 27 Nettleton Dr, Woodbridge, CT 06525 | 2007-01-03 |
| 1710586300 | Potomac Audiology LLC | Otolaryngology | 14000 Crown Ct Ste 201, Woodbridge, VA 22193-1463 | 2020-10-23 |
| 1689801656 | Alex Y Cheng | Otolaryngology | 14000 Crown Ct Ste 201, Woodbridge, VA 22193-1460 | 2009-06-17 |
| 1386748572 | Ali Moghtader | Otolaryngology | 14904 Jefferson Davis Highway, Woodbridge, VA 22191 | 2006-09-11 |
| 1003849720 | Commonwealth Ear, Nose & Throat Associates, LLC | Otolaryngology | 2280 Opitz Blvd, Suite 340, Woodbridge, VA 22191 | 2006-07-08 |
| 1528046349 | Stephen Michael Bane | Otolaryngology | 2280 Opitz Blvd, Suite 340, Woodbridge, VA 22191-3362 | 2006-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174005417 | Roanoke Valley Ent & Allergy PC | Otolaryngology | 2154 Mcvitty Rd, Second Floor, Roanoke, VA 24018 | 2018-09-04 |
| 1629459243 | Kevin James Quinn | Otolaryngology | 1200 E Broad St # 980257, Richmond, VA 23298 | 2015-06-10 |
| 1356778641 | Stat, LLC | Otolaryngology | 10812 Weather Vane Rd, Richmond, VA 23238-4161 | 2013-10-01 |
| 1134564073 | Ear, Nose, Throat & Allergy Consultants, PC | Otolaryngology | 26208 Lee Highway, Abingdon, VA 24211-7504 | 2013-05-06 |
| 1467790477 | Marco Aurelio Merida | Otolaryngology | 7216 Farm Meadow Ct, Mc Lean, VA 22101-5657 | 2013-01-25 |
| 1609142355 | Neelima Tummala | Otolaryngology | 1860 Town Center Dr Ste 420, Reston, VA 20190-5901 | 2012-03-27 |
| 1346512225 | John Laurence Manwaring | Otolaryngology | 7734 Retreat Ln, Warrenton, VA 20186-7546 | 2012-02-07 |
| 1508151887 | Jose Luis Mattos | Otolaryngology | 415 Ray C. Hunt Dr Ste 2200, Charlottesville, VA 22903-0001 | 2011-06-14 |
| 1982998852 | Blue Ridge Medical Management Corporation | Otolaryngology | 7021 W Lee Highway, Suite B, Rural Retreat, VA 24368-0000 | 2011-06-08 |
| 1609168327 | Jae Y Kim | Otolaryngology | 2200 Wilson Blvd Ste 102-219, Arlington, VA 22201-3397 | 2011-05-12 |
| Find all providers with the same taxonomy | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
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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.