Look up the most recent NPI and PECOS records

Maura Jean Sughrue

Family Medicine

Allopathic & Osteopathic Physicians

3650 Joseph Siewick Dr, Ste 400, Fairfax, VA 22033-1710

(703) 391-2020

PECOS Enrollment

This provider is enrolled in PECOS as MAURA SUGHRUE.

Based on the most recent information from CMS, provider Maura Jean Sughrue is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1881688844
Provider Type
Individual
Full Name
Sughrue, Maura Jean
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
9/7/2005
Last Updated
10/19/2020

Contact Information

Practice Location

3650 Joseph Siewick Dr, Ste 400, Fairfax, VA 22033-1710

(703) 391-2020

(703) 391-1211

Mailing Location

PO Box 791128, Baltimore, MD 21279-1128

(703) 391-2020

(703) 391-1211

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 0101035222 Virginia

Provider Identifiers

ID	Description	Issuer
ID 080182899	Description Other	Issuer RR MEDICARE Virginia
ID 05622409	Description Medicaid	Issuer Unlisted Virginia
ID 005622409	Description Medicaid	Issuer Unlisted Virginia

Maura Jean Sughrue

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Ehrlich, Thomas Paul

Law, Adrienne M

Kerrigan, Michael

Massmann, Aubrey

Clark, Craig Charles

Davis, Erin Mae

Mccormally, Terence James

Chen, Ziyan

Yi, Heon Soo

Givens, Nathan Thomas