DR. WENDY RUTH GOTTLIEB M.D.
NPI 1073573382
Specialist in Reston, VA

Active since March 23, 2006Opted out of Medicare · through Jan 1, 2028
1800 TOWN CENTER DR, SUITE 418, RESTON, VA 20190(703) 668-9499(703) 689-4998 Get Directions Write a Review

NPPES record last updated: November 12, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Wendy Ruth Gottlieb M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WENDY RUTH GOTTLIEB M.D. (NPI 1073573382) is an individual specialist in Reston, Virginia, licensed in Virginia (0101231213) and active in the NPI registry since March 2006. She has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1073573382
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameDR. WENDY RUTH GOTTLIEBCredential: M.D.
Location Address1800 TOWN CENTER DR, SUITE 418Reston, VA 20190-3215
Mailing Address1800 Town Center Dr, Suite 418Reston, VA 20190-3215 · (703) 668-9499 · Fax (703) 689-4998
Fax(703) 689-4998
Sole ProprietorYes
Enumeration DateMarch 23, 2006
Last NPPES UpdateNovember 12, 2014
NPI 1073573382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in VA · 0101231213
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1800 TOWN CENTER DR, Reston, VA 20190

Other Identifiers 3

Medicare UPINH51211VA
Medicare PING01351W01VA
Medicaid01-00444448VA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Wendy Ruth Gottlieb M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1800 TOWN CENTER DR, SUITE 415
RESTON, VA 20190
Dermatology
1800 TOWN CENTER DR, STE 415
RESTON, VA 20190
Counselor (Professional)
1800 TOWN CENTER DR, SUITE 420
RESTON, VA 20190
Obstetrics & Gynecology
1800 TOWN CENTER DR, SUITE # 222
RESTON, VA 20190
Family Medicine
1800 TOWN CENTER DR, SUITE 310
RESTON, VA 20190
Psychiatry & Neurology (Addiction Psychiatry)
1800 TOWN CENTER DR, STE 420
RESTON, VA 20190
Specialist
1800 TOWN CENTER DR, SUITE 420
RESTON, VA 20190
Psychologist
1800 TOWN CENTER DR, STE 411
RESTON, VA 20190

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073573382, enumerated as an "individual" on March 23, 2006.

The provider is located at 1800 TOWN CENTER DR SUITE 418 RESTON, VA 20190 and the phone number is (703) 668-9499.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.