Individual provider Active NPI

Liana E Matevosian, NP

  • Nurse Practitioner
  • Alexandria, VA
National Provider Identifier
1033608989
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024175817 Issued in VA
Practice address
4320 Seminary Rd
Alexandria, VA 22304-1535
Phone
(703) 504-3000
Fax
(703) 504-3388
NPI assigned
May 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024175817 VA
Nurse Practitioner 363L00000X 0024175817 VA Primary

Addresses

Primary practice location

4320 Seminary Rd
Alexandria, VA 22304-1535

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

13104 Cross Keys Ct
Fairfax, VA 22033-1426
Phone (703) 944-8546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190305002547 DC Practitioner - Nurse Practitioner 0244579498 Reassigns benefits to 2 organizations
I20260108002954 VA Practitioner - Nurse Practitioner 0244579498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 771-2960

8503 Arlington Blvd
Fairfax, VA 22031-4628
Phone (703) 970-2670

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024175817VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Hospice Inc. Current Accepting new patients
Fairfax Internal Medicine Associates, PC CurrentSince Jan 12, 2019 Accepting new patients
Inova Health Care Services CurrentSince Jun 14, 2021 Accepting new patients
East Coast Valley Home Health Inc CurrentSince Feb 7, 2024 Accepting new patients
Inova Health Care Services CurrentSince Jun 14, 2021 Accepting new patients

Locations

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

8503 Arlington Blvd
Fairfax, VA 22031
Phone (703) 970-2670

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

8302 Old Courthouse Rd
Ste C
Vienna, VA 22182
Phone (703) 462-8138

Interoperability endpoints

  • Direct secure messaging: lmatevosian587469@soc.inova.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
East Coast Valley Home Health IncFairfax, VA, CCN 497817 Home health agency 5% Or Greater Direct Ownership Interest (33%)
W-2 Managing Employee (33%)
Feb 7, 2024
Feb 7, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1033608989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SEMINARY RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041535",
            "telephone_number": "703-504-3000",
            "fax_number": "703-504-3388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13104 Cross Keys Ct",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331426",
            "country_code": "US",
            "telephone_number": "703-944-8546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATEVOSIAN",
        "first_name": "LIANA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024175817",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024175817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.