SPECIALTY PHYSICIANS OF NORTHERN VIRGINIA, LLC
NPI 1114157054
Surgery in Dulles, VA
About Specialty Physicians Of Northern Virginia, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SPECIALTY PHYSICIANS OF NORTHERN VIRGINIA, LLC (NPI 1114157054) is a healthcare organization registered as a surgery in Dulles, Virginia and active in the NPI registry since July 2009. The organization lists Suzanne Bergamo, Vp, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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)
Specialty Physicians Of Northern Virginia, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 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
14Medicare enrollment records show 14 clinicians reassign Medicare billing to Specialty Physicians Of Northern Virginia, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 9 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (14)
Dulles, VA 20166
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently 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 Specialty Physicians Of Northern Virginia, LLC's NPI number?
The NPI number for Specialty Physicians Of Northern Virginia, LLC is 1114157054. It was assigned to this organization in the NPPES registry on July 24, 2009.
Where is Specialty Physicians Of Northern Virginia, LLC located?
Specialty Physicians Of Northern Virginia, LLC is located at 24430 Stone Springs Blvd, Dulles, VA 20166. The listed phone number is (703) 665-2430.
What is Specialty Physicians Of Northern Virginia, LLC's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Specialty Physicians Of Northern Virginia, LLC enrolled in Medicare?
Yes. Specialty Physicians Of Northern Virginia, LLC is registered in the Medicare PECOS enrollment system.
When is Specialty Physicians Of Northern Virginia, LLC'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 February 28, 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 Specialty Physicians Of Northern Virginia, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 5 Medicare specialties reassign their Medicare billing to Specialty Physicians Of Northern Virginia, LLC. 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. The largest specialties are Nurse Practitioner (6), Obstetrics/Gynecology (4) and Certified Nurse Midwife (CNM) (2). Of these, 2 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Specialty Physicians Of Northern Virginia, LLC was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.
# Specialty Physicians Of Northern Virginia, Llc · NPI 1114157054
Surgery organization in Dulles, Virginia. Organization record, active in the CMS NPPES registry since July 24, 2009.
## Identity
- **NPI:** 1114157054 (Entity type: Organization)
- **Enumerated:** July 24, 2009
- **Primary specialty:** Surgery · taxonomy 208600000X
- **Organization subpart:** No
- **Authorized official:** Suzanne Bergamo, VP
## Practice location
- **Address:** 24430 STONE SPRINGS BLVD, Dulles, VA 20166-2267
- **Phone:** (703) 665-2430
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, District of Columbia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 14 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Obstetrics/Gynecology (4), Certified Nurse Midwife (CNM) (2); 2 practice at this address and 9 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 20, 2025
- **Other identifiers:** Medicaid 1114157054 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1114157054) · Data from the CMS NPPES public registry.