Individual ProviderAinsley LundgrenFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address3650 Joseph Siewick Dr Ste 400, Fairfax, VA 22033-1715(703) 391-2020PECOS EnrollmentBased on the most recent information from CMS, provider Ainsley Lundgren is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1508436106Provider TypeIndividualFull NameLundgren, AinsleyCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date6/28/2021Last Updated6/28/2021Contact InformationPractice LocationPractice Address3650 Joseph Siewick Dr Ste 400, Fairfax, VA 22033-1715Phone(703) 391-2020FaxUnlisted FaxMailing LocationMailing Address3650 Joseph Siewick Dr Ste 400, Fairfax, VA 22033-1715PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense0116035763Virginia