ELIZABETH ANN BENNETT (MD) – Family Medicine Physician, NPI 1710959234

ELIZABETH ANN BENNETT (MD) is a healthcare provider. based in Burke, Virginia. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 0101236782 (VA). The NPI Number for ELIZABETH ANN BENNETT (MD) is 1710959234

Main info

Female
Sole Proprietor
31 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH ANN BENNETT (MD)
NPI
1710959234
Phone
(571) 749-8420
Address
9159 BLOOM CT
Enumeration Date
7 February 2006
Last Update Date
7 November 2021

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5717498420
Graduation Year
1995 (31 years ago)
PAC ID
2668441726
Professional Enrollment ID
I20040927000636
Address ID
VA22015XXXXBUXXXXXXXXXX00
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,174 FAMILY PRACTICE in VA

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Provider Addresses for ELIZABETH ANN BENNETT (MD)

  • 9159, Bloom Court, Red Fox Forest, Burke, Fairfax County, Virginia, 22015, United States

    BURKE, VA 220151643

    Phone: (571) 749-8420

    Fax: (855) 955-0445

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-01-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040927000636IFamily PracticeDCTBD
I20130103000094IFamily PracticeVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 22015)

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Reviews

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Frequently asked questions

How do I look up ELIZABETH ANN BENNETT (MD) by NPI?
Use NPI 1710959234 when you need to reference ELIZABETH ANN BENNETT (MD) in forms, claims, or directories.
Does this profile mean ELIZABETH ANN BENNETT (MD) is currently active?
Yes — ELIZABETH ANN BENNETT (MD) appears active in the national provider directory.
Does ELIZABETH ANN BENNETT (MD) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for ELIZABETH ANN BENNETT (MD). Clinical services aligned with this taxonomy classification.
Where does public data place ELIZABETH ANN BENNETT (MD)?
The snapshot lists Burke, Virginia for ELIZABETH ANN BENNETT (MD); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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