BLUE NILE MEDICAL CENTER PC
NPI 1073544656
Internal Medicine in Alexandria, VA
About Blue Nile Medical Center Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE NILE MEDICAL CENTER PC (NPI 1073544656) is a healthcare organization registered as an internal medicine in Alexandria, Virginia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 20, 2028 and lists Tedla Anbessie, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Blue Nile Medical Center Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Blue Nile Medical Center PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 49D1000545
Blue Nile Medical Center, PC · Alexandria, VAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blue Nile Medical Center PC's NPI number?
The NPI number for Blue Nile Medical Center PC is 1073544656. It was assigned to this organization in the NPPES registry on July 5, 2006.
Where is Blue Nile Medical Center PC located?
Blue Nile Medical Center PC is located at 85 S Bragg St Suite 100, Alexandria, VA 22312. The listed phone number is (703) 845-0700.
What is Blue Nile Medical Center PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Blue Nile Medical Center PC enrolled in Medicare?
Yes. Blue Nile Medical Center PC is registered in the Medicare PECOS enrollment system.
When is Blue Nile Medical Center PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (District of Columbia, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Blue Nile Medical Center PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Internal Medicine, reassign their Medicare billing to Blue Nile Medical Center PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Blue Nile Medical Center PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 49D1000545) is associated with this NPI, valid through August 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Blue Nile Medical Center PC was last updated on December 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Blue Nile Medical Center Pc · NPI 1073544656
Internal Medicine organization in Alexandria, Virginia. Organization record, active in the CMS NPPES registry since July 5, 2006.
## Identity
- **NPI:** 1073544656 (Entity type: Organization)
- **Enumerated:** July 5, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Tedla Anbessie, PHYSICIAN
## Practice location
- **Address:** 85 S BRAGG ST, SUITE 100, Alexandria, VA 22312-2797
- **Phone:** (703) 845-0700 · **Fax:** (703) 794-2269
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, District of Columbia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 6, 2011
- **Other identifiers:** Medicare PIN C09674; Medicare PIN G01742
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1073544656) · Data from the CMS NPPES public registry.