MEDICARE: PRADEEP R. NAYAK M.D.

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	207RA0002X	Adult Congenital Heart Disease Physician	0101049006	VA
2	207RC0000X	Cardiovascular Disease Physician	0101049006	VA
3	207R00000X	Internal Medicine Physician	0101049006	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	060062643	OTHER	VA	RAILROAD MEDICARE VA#
4	060034779	OTHER	DC	RAILROAD MEDICARE DC #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922000181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRADEEP R. NAYAK M.D.

Provider Business Mailing Address
First Line	:	3580 JOSEPH SIEWICK DR STE 305
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-1764
Country	:	US
Telephone Number	:	703-648-3266
Fax Number	:	703-591-1660

Provider Business Practice Location Address
First Line	:	3580 JOSEPH SIEWICK DR STE 305
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-1764
Country	:	US
Telephone Number	:	703-648-3266
Fax Number	:	703-648-3264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	02/20/2026

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Directions to “ PRADEEP R. NAYAK M.D.” Practice Location

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