PENDERBROOK INTERNAL MEDICINE AND WELLNESS, PLLC
NPI 1972832608
Internal Medicine in Fairfax, VA

Q: What is Penderbrook Internal Medicine And Wellness, PLLC's specialty?

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

Active since December 08, 2009

4001 FAIR RIDGE DR, SUITE 206, FAIRFAX, VA 22033(703) 716-5404(703) 716-5410 Get Directions Write a Review

NPPES record last updated: September 29, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Penderbrook Internal Medicine And Wellness, Pllc NPPES

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

PENDERBROOK INTERNAL MEDICINE AND WELLNESS, PLLC (NPI 1972832608) is a healthcare organization registered as an internal medicine in Fairfax, Virginia and active in the NPI registry since December 2009. The organization lists Thien Quang Dat Le, Owner, as its authorized official.

NPPES Registry Identity

NPI1972832608

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NamePENDERBROOK INTERNAL MEDICINE AND WELLNESS, PLLC

Location Address4001 FAIR RIDGE DR, SUITE 206Fairfax, VA 22033-2917

Mailing Address4001 Fair Ridge Dr, Suite 206Fairfax, VA 22033-2917 · (703) 716-5404 · Fax (703) 716-5410

Phone(703) 716-5404

Fax(703) 716-5410

Organization SubpartNo

Authorized OfficialThien Quang Dat LeOwner · (703) 716-5404

Enumeration DateDecember 8, 2009

Last NPPES UpdateSeptember 29, 2011

✔ NPI 1972832608 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 · 0101840408

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.

4001 FAIR RIDGE DR, Fairfax, VA 22033

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Penderbrook Internal Medicine And Wellness, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Penderbrook Internal Medicine And Wellness, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Thienquang Le, M.D.

Internal Medicine

NPI 1538254875

4001 FAIR RIDGE DR SUITE 206
Fairfax, VA 22033

(703) 716-5404

✔ PECOS✔ Accepts MedicareSame address

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 Penderbrook Internal Medicine And Wellness, PLLC's NPI number?

The NPI number for Penderbrook Internal Medicine And Wellness, PLLC is 1972832608. It was assigned to this organization in the NPPES registry on December 8, 2009.

Where is Penderbrook Internal Medicine And Wellness, PLLC located?

Penderbrook Internal Medicine And Wellness, PLLC is located at 4001 Fair Ridge Dr Suite 206, Fairfax, VA 22033. The listed phone number is (703) 716-5404.

What is Penderbrook Internal Medicine And Wellness, PLLC's specialty?

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

Is Penderbrook Internal Medicine And Wellness, PLLC enrolled in Medicare?

Yes. Penderbrook Internal Medicine And Wellness, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Penderbrook Internal Medicine And Wellness, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Penderbrook Internal Medicine And Wellness, PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Penderbrook Internal Medicine And Wellness, PLLC was last updated on September 29, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.