Specialty Physicians of Northern Virginia, LLC
NPI 1114157054ActiveOrganization· Surgery· Dulles, VA
Surgery in Dulles, Virginia, registered in NPPES in July 2009. The authorized official on file is Suzanne Bergamo, Vp. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1114157054 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 24, 2009 |
| Last updated in NPPES | Nov 20, 2025 |
| Certified by provider | Nov 20, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (DC); Part B Supplier - Clinic/Group Practice (VA) |
|---|
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