ADVANCED BRAIN CENTERS OF VA — NPI 1659067122 (Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) in RESTON, VA)

CMS-1500 Box 24J / 33a • NPI

1659067122

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207PE0005X (CMS 93)

Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)

Box 32 Service Location & ZIP+4

1860 TOWN CENTER DRIVE, SUITE G220, RESTON, VA, 20190

Official NPPES Practice Location

Practice Phone & Referral Fax

(571) 201-8238

Fax: (703) 709-1119

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1659067122 (ADVANCED BRAIN CENTERS OF VA) 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	`1659067122` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVANCED BRAIN CENTERS OF VA
Plain-English Specialty	Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: `207PE0005X` (Emergency Medicine, Undersea and Hyperbaric Medicine)
Certifying / Licensing Body	American Board of Emergency Medicine (ABEM)
Practice Location Address	1860 TOWN CENTER DRIVE, SUITE G220, RESTON, VA, 20190
Practice Telephone / Fax	Tel: (571) 201-8238 \| Fax: (703) 709-1119
Administrative Mailing Address	1860 TOWN CENTER DRIVE, RESTON, VA, 20190
Enumeration & Last Sync	Enumerated: 2023-04-17 \| CMS Record Updated: 2023-08-16
Authorized Official	PHILLIP DEFINA (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1860 TOWN CENTER DRIVE, SUITE G220, RESTON, VA, 20190

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Plain-English Taxonomy & CMS Crosswalk (207PE0005X)

What Does Taxonomy Code 207PE0005X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207PE0005X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 93 (Physician/Emergency Medicine) • CMS Code D4 (Undersea and Hyperbaric Medicine)
Certifying / Accrediting Authority: American Board of Emergency Medicine (ABEM)
Clinical Scope: Immediate life-or-limb emergencies, severe chest pain, stroke symptoms, deep contaminated wounds needing tetanus prophylaxis, or severe dehydration.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADVANCED BRAIN CENTERS OF VA)

Typical CPT / Diagnostic Procedures:

Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting

Common Therapeutic Classes:

Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207PE0005X` — Emergency Medicine, Undersea and Hyperbaric Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADVANCED BRAIN CENTERS OF VA (NPI #1659067122)