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Jason Shenqing Fang

Internal Medicine

Allopathic & Osteopathic Physicians

3300 Gallows Rd, Falls Church, VA 22042-3307

PECOS Enrollment

This provider is enrolled in PECOS as JASON FANG.

Based on the most recent information from CMS, provider Jason Shenqing Fang 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 today at 10:50 AM.

Profile Details

Provider ID
1487114120
Provider Type
Individual
Full Name
Fang, Jason Shenqing
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/20/2019
Last Updated
11/2/2022

Contact Information

Practice Location

3300 Gallows Rd, Falls Church, VA 22042-3307

(703) 776-3582

(703) 776-3020

Mailing Location

PO Box 37174, Baltimore, MD 21297-3174

(571) 423-5699

(571) 423-5698

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 0101275392 Virginia
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Jason Shenqing Fang

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Witt, Rebecca

Demoz, Elias G

Groninger, James Hunter

Henry, Madhu Lakshman

Borgschulte, Gitte M

Krecko, Kristina Reist

Morales, Mario Alberto

Garcia, Ivan F

Erario, Madeline

Groves, Stephen