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DR. MINGLIARTI TJAHJANA M.D.
NPI 1649280215
Internal Medicine in Reston, VA

Active since August 08, 2006Opted out of Medicare · through Mar 31, 2028
1850 TOWN CENTER PKWY, SUITE 410, RESTON, VA 20190(571) 572-9198(571) 482-6080 Get Directions Write a Review

NPPES record last updated: December 9, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Mingliarti Tjahjana M.d. NPPES

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

DR. MINGLIARTI TJAHJANA M.D. (NPI 1649280215) is an individual internal medicine provider in Reston, Virginia, licensed in Virginia (0101236144) and active in the NPI registry since August 2006. She has opted out of Medicare through March 31, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1649280215
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. MINGLIARTI TJAHJANACredential: M.D.
Location Address1850 TOWN CENTER PKWY, SUITE 410Reston, VA 20190-3219
Mailing Address12504 Alexander Cornell DrFairfax, VA 22033-2437 · (571) 338-9054 · Fax (571) 482-6080
Phone(571) 572-9198
Fax(571) 482-6080
Sole ProprietorNo
Enumeration DateAugust 8, 2006
Last NPPES UpdateDecember 9, 2016
✔ NPI 1649280215 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 · 0101236144
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.
1850 TOWN CENTER PKWY, Reston, VA 20190
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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. Mingliarti Tjahjana 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 March 31, 2016 through March 31, 2028.

Opt-Out Effective DateMarch 31, 2016
Opt-Out In Effect ThroughMarch 31, 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20190 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

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.

MEDSTAR MEDICAL GROUP II LLC
General Practice
1850 TOWN CENTER PKWY
RESTON, VA 20190
Fairfax County (202) 877-7685
DR. DAVID E KARDON MD
Pathology (Anatomic Pathology & Clinical Pathology)
1850 TOWN CENTER PKWY
RESTON, VA 20190
Fairfax County (703) 689-9093
DR. ANDREW HARRIS GORDON M.D., PH.D.
Physical Medicine & Rehabilitation
1850 TOWN CENTER PKWY
RESTON, VA 20190
Fairfax County (703) 949-9660
BERNARD JAMES GAMIAO
Occupational Therapist
1850 TOWN CENTER PKWY
RESTON, VA 20190
Fairfax County (703) 689-9000
SEON H LEE MD
Emergency Medicine
1850 TOWN CENTER PKWY, RESTON HOSPITAL CENTER
RESTON, VA 20190
Fairfax County (703) 689-9037
MRS. DIANE D ZHAO MD
Physical Medicine & Rehabilitation
1850 TOWN CENTER PKWY
RESTON, VA 20190
Fairfax County (703) 689-9000
DR. JAMES L TORRENS MD
Anesthesiology
1850 TOWN CENTER PKWY, RESTON HOSPITAL CENTER
RESTON, VA 20190
Fairfax County (703) 471-0919
JOHN M YOUNG CRNA
Nurse Anesthetist, Certified Registered
1850 TOWN CENTER PKWY
RESTON, VA 20190
Fairfax County (703) 471-0919

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 Mingliarti Tjahjana's NPI number?

The NPI number for Mingliarti Tjahjana is 1649280215. It was assigned to this individual provider in the NPPES registry on August 8, 2006.

Where is Mingliarti Tjahjana located?

Mingliarti Tjahjana practices at 1850 Town Center Pkwy Suite 410, Reston, VA 20190. The listed phone number is (571) 572-9198.

What is Mingliarti Tjahjana's specialty?

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

Is Mingliarti Tjahjana enrolled in Medicare?

No. Mingliarti Tjahjana has opted out of Medicare through March 31, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Mingliarti Tjahjana was last updated on December 9, 2016. 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.