OrganizationActive
Blue Mantle Medicine PLLC
NPI 1417658980 · Pediatrics Physician · Fairfax, VA
Blue Mantle Medicine PLLC is a Pediatrics Physician organization in Fairfax, VA (NPI 1417658980).
Provider details
- NPI number
- 1417658980
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sita Canady, MD(540) 645-1856
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4001 Fair Ridge Dr Ste 305
Fairfax, VA 22033-2917
Phone: (540) 701-4767
Fax: (703) 520-9880
Street-level locationGet directions
Mailing address
4001 Fair Ridge Dr Ste 305
Fairfax, VA 22033-2917
Registry dates
- Enumerated
- 2023-03-13
- Last updated
- 2023-03-13
- Certified
- 2023-03-13
Frequently asked questions
- What is Blue Mantle Medicine PLLC's NPI number?
- Blue Mantle Medicine PLLC's National Provider Identifier (NPI) is 1417658980, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Blue Mantle Medicine PLLC?
- Blue Mantle Medicine PLLC is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Blue Mantle Medicine PLLC located?
- Blue Mantle Medicine PLLC's practice location on file with NPPES is 4001 Fair Ridge Dr Ste 305, Fairfax, VA 22033-2917.
- What is Blue Mantle Medicine PLLC's phone number?
- The practice phone number listed in the NPPES registry for Blue Mantle Medicine PLLC is (540) 701-4767.
- Who is the authorized official for Blue Mantle Medicine PLLC?
- The authorized official listed on Blue Mantle Medicine PLLC's NPPES record is Sita Canady, MD. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Blue Mantle Medicine PLLC's NPI active?
- Yes — Blue Mantle Medicine PLLC's NPI (1417658980) is active in the NPPES registry as of the last update on 2023-03-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.