PEDIATRICARE OF NORTHERN VIRGINIA, P.C.
NPI 1104994623
Pediatrics in Manassas, VA
About Pediatricare Of Northern Virginia, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEDIATRICARE OF NORTHERN VIRGINIA, P.C. (NPI 1104994623) is a healthcare organization registered as a pediatrics in Manassas, Virginia and active in the NPI registry since December 2006. The organization holds 2 active CLIA laboratory certificates and lists Frank James Giancola, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Pediatricare Of Northern Virginia, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
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
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Pediatricare Of Northern Virginia, P.C., which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.
Clinicians, nearest first (8)
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 2
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 49D0918354
Pediatricare Of Northern Virginia, PC · Manassas, VACertificate of Waiver 49D1105606
Pediatric Care Of Northern Virginia · Haymarket, 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 Pediatricare Of Northern Virginia, P.C.'s NPI number?
The NPI number for Pediatricare Of Northern Virginia, P.C. is 1104994623. It was assigned to this organization in the NPPES registry on December 1, 2006.
Where is Pediatricare Of Northern Virginia, P.C. located?
Pediatricare Of Northern Virginia, P.C. is located at 8640 Sudley Rd Suite 306, Manassas, VA 20110. The listed phone number is (703) 330-3939.
What is Pediatricare Of Northern Virginia, P.C.'s specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Pediatricare Of Northern Virginia, P.C. enrolled in Medicare?
Yes. Pediatricare Of Northern Virginia, P.C. is registered in the Medicare PECOS enrollment system.
When is Pediatricare Of Northern Virginia, P.C.'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 (Virginia, Clinic/Group Practice) is due for revalidation by March 31, 2027. 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 Pediatricare Of Northern Virginia, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Pediatric Medicine, reassign their Medicare billing to Pediatricare Of Northern Virginia, P.C.. 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, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pediatricare Of Northern Virginia, P.C. hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Pediatricare Of Northern Virginia, P.C. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Pediatricare Of Northern Virginia, P.c. · NPI 1104994623
Pediatrics organization in Manassas, Virginia. Organization record, active in the CMS NPPES registry since December 1, 2006.
## Identity
- **NPI:** 1104994623 (Entity type: Organization)
- **Enumerated:** December 1, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Organization subpart:** No
- **Authorized official:** Frank Giancola, PRESIDENT
## Practice location
- **Address:** 8640 SUDLEY RD, SUITE 306, Manassas, VA 20110-4420
- **Phone:** (703) 330-3939 · **Fax:** (703) 331-0959
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Virginia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 8 clinicians (Pediatric Medicine) reassign Medicare billing to this organization (form CMS-855R); 5 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104994623) · Data from the CMS NPPES public registry.