AESTHETIC CENTER FOR PLASTIC SURGERY — NPI 1134619166 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Plastic and Reconstructive Surgery in MC LEAN, VA)

CMS-1500 Box 24J / 33a • NPI

1134619166

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

2086S0122X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Plastic and Reconstructive Surgery

Box 32 Service Location & ZIP+4

6845 ELM ST STE 708, MC LEAN, VA, 22101-3851

✓ 9-Digit EDI 837 ZIP+4 (22101-3851)

Practice Phone & Referral Fax

(703) 893-1111

Fax: (703) 760-9565

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1134619166 (AESTHETIC CENTER FOR PLASTIC SURGERY) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1134619166` (NPI-2 Organization / Facility)
Provider / Legal Name	AESTHETIC CENTER FOR PLASTIC SURGERY
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Plastic and Reconstructive Surgery NUCC Code: `2086S0122X` (Surgery, Plastic and Reconstructive Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	6845 ELM ST STE 708, MC LEAN, VA, 22101-3851
Practice Telephone / Fax	Tel: (703) 893-1111 \| Fax: (703) 760-9565
Administrative Mailing Address	6845 ELM ST STE 708, MC LEAN, VA, 22101-3851
Enumeration & Last Sync	Enumerated: 2018-05-15 \| CMS Record Updated: 2018-05-15
Authorized Official	GLORIA DUDA (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6845 ELM ST STE 708, MC LEAN, VA, 22101-3851

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Plain-English Taxonomy & CMS Crosswalk (2086S0122X)

What Does Taxonomy Code 2086S0122X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2086S0122X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Plastic and Reconstructive Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Surgery, Plastic and Reconstructive Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AESTHETIC CENTER FOR PLASTIC SURGERY)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2086S0122X` — Surgery, Plastic and Reconstructive Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Plastic and Reconstructive Surgery	State: VA \| License: `0101039385` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AESTHETIC CENTER FOR PLASTIC SURGERY (NPI #1134619166)