MEDICARE: CAPITAL PALLIATIVE CARE CONSULTANTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1275541013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL PALLIATIVE CARE CONSULTANTS, LLC

Provider Business Mailing Address
First Line	:	3180 FAIRVIEW PARK DR STE 500
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-4583
Country	:	US
Telephone Number	:	703-538-2043
Fax Number	:

Provider Business Practice Location Address
First Line	:	3180 FAIRVIEW PARK DR STE 500
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-4583
Country	:	US
Telephone Number	:	703-538-2043
Fax Number	:

Authorized Official
Title or Position	:	VP, LEGAL SERVICES
Name	:	CRYSTAL BUCCIARELLI
Credential	:
Telephone Number	:	813-871-8075

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	02/04/2026

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