ACTIVE HEALTH LLC — NPI 1215812458 (Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) in ASHBURN, VA)

CMS-1500 Box 24J / 33a • NPI

1215812458

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207R00000X (CMS 11)

Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)

Box 32 Service Location & ZIP+4

44121 LEESBURG PIKE STE 285, ASHBURN, VA, 20147-5673

✓ 9-Digit EDI 837 ZIP+4 (20147-5673)

Practice Phone & Referral Fax

(571) 918-0119

Fax: (888) 507-4671

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1215812458 (ACTIVE HEALTH LLC) 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	`1215812458` (NPI-2 Organization / Facility)
Provider / Legal Name	ACTIVE HEALTH LLC
Plain-English Specialty	Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: `207R00000X` (Internal Medicine)
Certifying / Licensing Body	American Board of Internal Medicine (ABIM)
Practice Location Address	44121 LEESBURG PIKE STE 285, ASHBURN, VA, 20147-5673
Practice Telephone / Fax	Tel: (571) 918-0119 \| Fax: (888) 507-4671
Administrative Mailing Address	42653 WILLOW BEND DR, BRAMBLETON, VA, 20148-6884
Enumeration & Last Sync	Enumerated: 2025-08-07 \| CMS Record Updated: 2026-08-11
Authorized Official	EMERENCIENNE DEUNGWE YONGA (OWNER / AUTHORIZED OFFICIAL)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

44121 LEESBURG PIKE STE 285, ASHBURN, VA, 20147-5673

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Plain-English Taxonomy & CMS Crosswalk (207R00000X)

What Does Taxonomy Code 207R00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207R00000X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 11 (Physician/Internal Medicine)
Certifying / Accrediting Authority: American Board of Internal Medicine (ABIM)
Clinical Scope: Managing multiple adult chronic conditions (diabetes, high blood pressure, high cholesterol, thyroid disorders) or investigating unexplained adult symptoms.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ACTIVE HEALTH LLC)

Typical CPT / Diagnostic Procedures:

Complex Multi-System Adult Diagnostic Workup (CPT 99204–99215)
Preoperative Medical Risk Assessment & Cardiac Clearance
Chronic Kidney, Hepatic & Metabolic Panel Interpretation
Adult Inpatient Hospitalist Management & Discharge Coordination

Common Therapeutic Classes:

Antihypertensives (ACE Inhibitors, ARBs, Calcium Channel Blockers, Thiazides)
Oral Antidiabetic Agents, Basal/Bolus Insulins & Lipid-Lowering Statins
Direct Oral Anticoagulants (Apixaban, Rivaroxaban) & Antiplatelets
Levothyroxine (Hypothyroidism) & Proton Pump Inhibitors (Pantoprazole)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207R00000X` — Internal Medicine Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ACTIVE HEALTH LLC (NPI #1215812458)