DR. KONDEH AUGUSTA GREAVES (MD DOCTOR OF MEDICIN) – Obstetrics & Gynecology Physician, NPI 1790854099
Obstetrics & Gynecology Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. KONDEH AUGUSTA GREAVES (MD DOCTOR OF MEDICIN)
807 SANTMYER DR SE
LEESBURG, VA 201755606
Phone: (571) 220-7450
Type: Mailing
Prince William Medical Center, 8700, Sudley Road, Country Place, Manassas, Manassas (city), Virginia, 20110, United States
PRINCE WILLIAM HOSPITAL
MANASSAS, VA 20110
Phone: (703) 396-5284
Fax: (703) 396-8051
Type: Location
814, Fountain Hall Court Northeast, Potomac Station, Leesburg, Loudoun County, Virginia, 20176, United States
LEESBURG, VA 201763650
Phone: (703) 396-5284
Fax: (703) 396-8051
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: 2005-05-20
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 |
|---|---|---|---|---|
| I20050519000152 | I | Obstetrics/Gynecology | DC | TBD |
| I20050520000157 | I | Obstetrics/Gynecology | VA | 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 20175)
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