PREMIER CARDIAC AND VASCULAR LLC – Cardiovascular Disease Physician, NPI 1366905523
Cardiovascular Disease Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PREMIER CARDIAC AND VASCULAR LLC
5411D Backlick Rd Ste 100
Springfield, VA 221513915
Phone: (703) 563-1575
Fax: (610) 629-3991
Type: Location
609 Jefferson Davis Highway
Suite 201
Fredericksburg, VA 224014566
Phone: (540) 666-6181
Fax: (571) 318-9438
Type: Location
1854 MACARTHUR DR
MC LEAN, VA 221015340
Phone: (917) 620-2718
Type: Mailing
Alma Lane, Springfield, Fairfax County, Virginia, 22151, United States
SPRINGFIELD, VA 221514014
Phone: (703) 827-3351
Type: Location
5105I Backlick Rd
Annandale, VA 220036065
Phone: (703) 563-1575
Fax: (610) 629-3991
Type: Location
406 CHATHAM SQUARE OFFICE PARK
FREDERICKSBURG, VA 224052585
Phone: (540) 666-6181
Fax: (571) 318-9438
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2020-07-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-08-31 (649 days ago).
Enrollment records
2
Earliest due date
2024-08-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20190710001567 | O | Clinic/Group Practice | DC | 2024-08-31 |
| O20200713000003 | O | Clinic/Group Practice | VA | 2025-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 22151)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.