Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Prashanth A Mally, MD

Individual provider Pain Medicine (Anesthesiology) Physician · NPI 1669649729

Prashanth A Mally, MD is an Anesthesiology in Fairfax, Virginia. Qualified in 2003, 23 years ago. Practices with Kaiser Foundation Health Plan of the Mid Atlantic States, Inc, a 1,934-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
23
Licensed in
VA
In the registry since
2008
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone: (703) 934-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Anesthesiology) Physician (primary) Taxonomy 207LP2900X · Licence 101244719 (VA)

Record details

NPI number1669649729
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 8, 2008
Last updated in NPPESNovember 23, 2021
Certification dateNovember 23, 2021
Mailing address2101 E Jefferson St, Kaiser Permanente Medicare Enrollment, Rockville, MD 20852-4908

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc — 1934 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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