DR. KENNETH R MIRKIN (M.D.) – Gastroenterology Physician, NPI 1952372542

DR. KENNETH R MIRKIN (M.D.) is a healthcare provider. based in Fairfax, Virginia. specializing in GASTROENTEROLOGY. They hold the professional credentials M.D.. They hold a License No. 0101036056 (VA). The NPI Number for DR. KENNETH R MIRKIN (M.D.) is 1952372542

Main info

Male
50 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENNETH R MIRKIN (M.D.)
NPI
1952372542
Phone
(703) 698-1775
Address
3022 Williams Dr
Enumeration Date
31 January 2006
Last Update Date
21 January 2025

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1976 (50 years ago)
PAC ID
4385660638
Professional Enrollment ID
I20240523000209
Address ID
SC299262730HI35XXXDRXX400
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

540 GASTROENTEROLOGY in VA

Provider Addresses for DR. KENNETH R MIRKIN (M.D.)

  • 3022 Williams Dr

    Suite 301

    Fairfax, VA 220314600

    Phone: (703) 698-1775

    Fax: (703) 641-8427

    Type: Location

  • 100 Elden St Ste 10

    Herndon, VA 201704833

    Phone: (703) 698-8960

    Type: Location

  • 3914 Centreville Rd Ste 350

    Chantilly, VA 201513289

    Phone: (703) 716-8700

    Type: Location

  • 3700 Joseph Siewick Dr Ste 308

    Fairfax, VA 220331739

    Phone: (703) 698-8960

    Fax: (647) 646-4744

    Type: Location

  • 120 Kings Way Ste 3500

    Williamsburg, VA 231852511

    Phone: (757) 221-0750

    Type: Location

  • 850 Enterprise Pkwy Ste 2000

    Hampton, VA 236666252

    Phone: (757) 599-6333

    Type: Location

  • Joseph Siewick Drive, Chantilly, Fairfax County, Virginia, 22033, United States

    FAIRFAX, VA 220331739

    Phone: (703) 698-8960

    Fax: (703) 716-8703

    Type: Mailing

  • Javier Road, Merrifield, Fairfax (city), Virginia, 22031, United States

    FAIRFAX, VA 22031

    Phone: (703) 698-8960

    Fax: (571) 494-5794

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 71 Open Payments records for all available years, with a total value of $1,144.

Total Amount is formed as General ($1,144) + Research ($0) + Ownership ($0) = $1,144.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: ABBVIE INC. ($182).

Total Amount

$1,144

General + Research + Ownership

Payments

71

Total payment records

General Amount

$1,144

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2024-05-23

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
I20110429000169IGastroenterologyDCTBD
I20240523000209IGastroenterologySCTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J3380Injection, vedolizumab, 1 mg9,00020$0
99214Established patient office or other outpatient visit, 30-39 minutes138116$0
45380Biopsy of large bowel using a flexible endoscope9595$0
99213Established patient office or other outpatient visit, 20-29 minutes7873$0
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope6060$0
View full utilization report →

Insurance plans in this area (ZIP 22031)

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Reviews

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Frequently asked questions

Can I use this page to confirm DR. KENNETH R MIRKIN (M.D.)'s NPI?
Yes. DR. KENNETH R MIRKIN (M.D.) is listed with NPI 1952372542 in the public NPI dataset.
Does CMS list DR. KENNETH R MIRKIN (M.D.) as active?
Yes — DR. KENNETH R MIRKIN (M.D.) is active in the NPI listing used on this page.
What taxonomy line describes DR. KENNETH R MIRKIN (M.D.)?
For research purposes, treat DR. KENNETH R MIRKIN (M.D.) as Gastroenterology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DR. KENNETH R MIRKIN (M.D.) on a map?
Expect Fairfax, Virginia as a primary anchor for DR. KENNETH R MIRKIN (M.D.) unless the record lists multiple sites.
Is the information about DR. KENNETH R MIRKIN (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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