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DR. BARRY B. EKDOM PH.D.
NPI 1457532756
Clinical Neuropsychologist in Fairfax, VA

Active since November 15, 2007Accepts Medicare Assignment
3040 WILLIAMS DR, SUITE 402, FAIRFAX, VA 22031(703) 573-3573(703) 573-3574 Get Directions Write a Review

NPPES record last updated: June 3, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Barry B. Ekdom Ph.d. NPPES

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

DR. BARRY B. EKDOM PH.D. (NPI 1457532756) is an individual clinical neuropsychologist in Fairfax, Virginia, licensed in Virginia (0810001775) and active in the NPI registry since November 2007. He is a graduate of Other (1985).

NPPES Registry Identity

NPI1457532756
Entity TypeIndividualMale
Primary Taxonomy103G00000X
Provider Legal NameDR. BARRY B. EKDOMCredential: PH.D.
Location Address3040 WILLIAMS DR, SUITE 402Fairfax, VA 22031-4618
Mailing Address3040 Williams Dr, Suite 402Fairfax, VA 22031-4618 · (703) 573-3573 · Fax (703) 573-3574
Phone(703) 573-3573
Fax(703) 573-3574
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateNovember 15, 2007
Last NPPES UpdateJune 3, 2024
NPPES CertifiedJune 3, 2024
✔ NPI 1457532756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in VA · 0810001775
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
3040 WILLIAMS DR, Fairfax, VA 22031
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Barry B. Ekdom Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608943840
PECOS Enrollment IDI20080930000305

Medicare Billing Reassignment

Medicare enrollment records show Barry Ekdom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Barry B Ekdom Phd, PC
Same address
Clinical Neuropsychologist
3040 WILLIAMS DR, SUITE 402
Fairfax, VA 22031
  • Reassigned Medicare billing, District of Columbia enrollment
  • 3 clinicians in this Medicare group
NPI 1194804914 (703) 573-3575

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

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

BARRY B EKDOM PHD, PC
Clinical Neuropsychologist
3040 WILLIAMS DR, SUITE 402
FAIRFAX, VA 22031
Fairfax County (703) 573-3575
DR. IRENA MORIN FEDOROVSKY PSY.D.
Psychologist (Clinical)
3040 WILLIAMS DR, SUITE # 402
FAIRFAX, VA 22031
Fairfax County (703) 573-3573
DR. MICHELLE SULLIVAN-GAST PSY.D.
Psychologist (Clinical)
3040 WILLIAMS DR, SUITE 402
FAIRFAX, VA 22031
Fairfax County (703) 573-3573
NANA DICKSON, DDS PC
Dentist
3040 WILLIAMS DR, SUITE #201
FAIRFAX, VA 22031
Fairfax County (571) 419-6897
DR. NANA DICKSON D.D.S.
Dentist (General Practice)
3040 WILLIAMS DR, STE. #201
FAIRFAX, VA 22031
Fairfax County (571) 419-6897

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 Barry Ekdom's NPI number?

The NPI number for Barry Ekdom is 1457532756. It was assigned to this individual provider in the NPPES registry on November 15, 2007.

Where is Barry Ekdom located?

Barry Ekdom practices at 3040 Williams Dr Suite 402, Fairfax, VA 22031. The listed phone number is (703) 573-3573.

What is Barry Ekdom's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Barry Ekdom enrolled in Medicare?

Yes. Barry Ekdom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Barry Ekdom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Barry Ekdom reassigns Medicare benefits to Barry B Ekdom Phd, PC (Fairfax, VA). The 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 Barry Ekdom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Barry Ekdom was last updated on June 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.