Virginia Functional Medicine Inc – Undersea and Hyperbaric Medicine (Preventive Medicine) Physician, NPI 1295495331

Virginia Functional Medicine Inc is a healthcare provider. based in Leesburg, Virginia. specializing in Undersea and Hyperbaric Medicine (Preventive Medicine) Physician. The NPI Number for Virginia Functional Medicine Inc is 1295495331

Main info

Organization
Name
Virginia Functional Medicine Inc
NPI
1295495331
Phone
(703) 938-1421
Address
19465 DEERFIELD AVE STE 308
Authorized Official
NATHANIEL DAVID GOREN C.O.O.
Enumeration Date
29 December 2021
Last Update Date
31 October 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness90
Years active:4State licenses:0Digital endpoints

Provider Addresses for Virginia Functional Medicine Inc

  • 19465 DEERFIELD AVE STE 308

    LEESBURG, VA 201761701

    Phone: (703) 938-1421

    Fax: (703) 938-1424

    Type: Location

  • 410 PINE ST SE STE 320

    VIENNA, VA 221804861

    Phone: (703) 462-4348

    Fax: (703) 938-1424

    Type: Mailing

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: 2024-03-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
O20240307000878OClinic/Group 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 20176)

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Reviews

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Frequently asked questions

How do I look up Virginia Functional Medicine Inc by NPI?
Use NPI 1295495331 when you need to reference Virginia Functional Medicine Inc in forms, claims, or directories.
Does this profile mean Virginia Functional Medicine Inc is currently active?
Yes — Virginia Functional Medicine Inc appears active in the national provider directory.
What kind of provider is Virginia Functional Medicine Inc?
The page reflects Undersea and Hyperbaric Medicine (Preventive Medicine) Physician for Virginia Functional Medicine Inc. Clinical services aligned with this taxonomy classification.
What location shows for Virginia Functional Medicine Inc?
We surface Leesburg, Virginia for Virginia Functional Medicine Inc based on available NPPES addresses.
Is Virginia Functional Medicine Inc a real provider?
This page reflects official NPPES data for NPI 1295495331. Always confirm identity and privileges with the practice and licensing boards.

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