EAR NOSE & THROAT SPECIALISTS OF NORTHERN VA – Otolaryngology Physician, NPI 1760588628
Otolaryngology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for EAR NOSE & THROAT SPECIALISTS OF NORTHERN VA
1005 N Glebe Rd Ste 500
Arlington, VA 222015702
Phone: (703) 644-7800
Fax: (703) 644-1508
Type: Location
8644 Sudley Rd Ste 114
Manassas, VA 201104425
Phone: (703) 644-7800
Fax: (703) 644-1508
Type: Location
6564 LOISDALE CT STE 205
SPRINGFIELD, VA 221501812
Phone: (703) 644-7800
Fax: (703) 644-1508
Type: Mailing
Leesburg Pike, West Falls Church, Virginia, 22044, United States
500
FALLS CHURCH, VA 220442102
Phone: (703) 536-2729
Fax: (703) 241-0381
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: 2005-01-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040607001176 | O | Clinic/Group Practice | VA | TBD |
| O20050111000180 | O | Clinic/Group Practice | DC | TBD |
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.
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 22201)
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