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ATUL P KAPADIA M.D.
NPI 1619986940
Internal Medicine in Woodbridge, VA

Active since August 05, 2006PECOS EnrolledAccepts Medicare Assignment
96.41/100
CMS Quality Rating
1966 OPITZ BLVD, WOODBRIDGE, VA 22191(703) 897-8389(571) 398-6358 Get Directions Write a Review

NPPES record last updated: March 6, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Atul P Kapadia M.d. NPPES

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

ATUL P KAPADIA M.D. (NPI 1619986940) is an individual internal medicine provider in Woodbridge, Virginia, licensed in Virginia (0101057778) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Sentara Northern Virginia Medical Center, and is a graduate of Other (1990).

NPPES Registry Identity

NPI1619986940
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameATUL P KAPADIACredential: M.D.
Location Address1966 OPITZ BLVDWoodbridge, VA 22191-3304
Mailing Address4900 N Centaurs CtAnnandale, VA 22003-4203 · (703) 897-8389 · Fax (703) 897-5669
Phone(703) 897-8389
Fax(571) 398-6358
Sole ProprietorNo
Medical School CMSOtherGraduated 1990
Enumeration DateAugust 5, 2006
Last NPPES UpdateMarch 6, 2017
✔ NPI 1619986940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in VA · 0101057778
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1966 OPITZ BLVD, Woodbridge, VA 22191
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Other Identifiers 9

Medicare UPING80749
Other385618VA · Anthem, Bcbs
Other020603979Tax Id
Medicare ID-Type Unspecified110008467VA · Medicare, Va
Medicare ID-Type Unspecified00B233C14DC · Medicare, Dc
Medicaid5873177VA
Other5282681VA · Aetna
Medicare ID-Type Unspecified110238660Railroad
Other2165485United Healthcare

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Atul P Kapadia M.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 ID9931190451
PECOS Enrollment IDI20040524000293
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
1,527 services521 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
1,075 services540 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
172 services172 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
167 services167 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
56 services52 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sentara Northern Virginia Medical Center

Acute Care Hospitals · Woodbridge, VA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490113
Location2300 Opitz BoulevardWoodbridge, VA 22191 · Prince William County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22191 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

96.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Promoting Interoperability100
Improvement Activities40
Cost88.05

Reported Quality Measures

Controlling High Blood Pressure
97%827 patients4/55-star benchmark: 98%
Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - Diabetes or Left Ventricular Systolic Dysfunction (LVEF <= 40%)
100%28 patients5/55-star benchmark: 100%
Coronary Artery Disease (CAD): Antiplatelet Therapy
100%107 patients5/55-star benchmark: 100%
Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation
100%332 patients5/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
6%225 patients4/55-star benchmark: 98%
e-Prescribing
94%3,649 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
100%1,248 patients5/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
99%759 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers57 claims197 services$6.11 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers21 claims29 services$1.14 avg. paid by Medicare
Adhesive remover, wipes, any type, each A4456
DME-Medical/Surgical Supplies · category DA000N
3 suppliers11 claims1,075 services$0.22 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063
DME-Orthotic Devices · category DF010N
2 suppliers13 claims460 services$2.62 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers15 claims89 services$1.86 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers11 claims11 services$28.76 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

PRACHAK T SIRIPRAKORN M.D. P.C.
Internal Medicine (Cardiovascular Disease)
1966 OPITZ BLVD
WOODBRIDGE, VA 22191
Prince William County (703) 491-2179
DR. PRACHAK T SIRIPRAKORN M.D.
Specialist
1966 OPITZ BLVD, SUITE 9
WOODBRIDGE, VA 22191
Prince William County (703) 491-2179

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 Atul Kapadia's NPI number?

The NPI number for Atul Kapadia is 1619986940. It was assigned to this individual provider in the NPPES registry on August 5, 2006.

Where is Atul Kapadia located?

Atul Kapadia practices at 1966 Opitz Blvd, Woodbridge, VA 22191. The listed phone number is (703) 897-8389.

What is Atul Kapadia's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Atul Kapadia enrolled in Medicare?

Yes. Atul Kapadia 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.

Is Atul Kapadia affiliated with any hospitals?

According to CMS data, Atul Kapadia is affiliated with Sentara Northern Virginia Medical Center.

When was this NPI record last updated?

The NPPES record for Atul Kapadia was last updated on March 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.