Individual provider Active NPI

Samuel Mayo, FNP

  • Family Nurse Practitioner
  • Falls Church, VA
National Provider Identifier
1033769872
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024180697 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-4001
Fax
(703) 776-7113
NPI assigned
Sep 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2312854 MA
Family Nurse Practitioner 363LF0000X 0024180697 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

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

Other practice location 1

10 Bellamy St
Brighton, MA 02135-1502
Phone (617) 782-8113

Other practice location 2

1500 N Beauregard St Ste 300
Alexandria, VA 22311-1715
Phone (703) 845-1500

Other practice location 3

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

Other practice location 4

7051 Heathcote Village Way Ste 230
Gainesville, VA 20155-3266
Phone (703) 391-4500

Other practice location 5

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

Other practice location 6

3580 Joseph Siewick Dr Ste 206
Fairfax, VA 22033-1764
Phone (703) 391-4500

Other practice location 7

8081 Innovation Park Dr Ste 900
Fairfax, VA 22031-4867
Phone (571) 472-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20210811000634 VA Practitioner - Nurse Practitioner 0941604060 Reassigns benefits to 2 organizations
I20210811002260 DC Practitioner - Nurse Practitioner 0941604060 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, shared by 24 NPIs, 1,821 clinicians

Practice addresses (Care Compare)

1500 N Beauregard St
Suite 300
Alexandria, VA 22311-1715
Phone (703) 845-1500

3800 Fettler Park Dr
Suite 312
Dumfries, VA 22025-2043
Phone (571) 472-6791

7051 Heathcote Village Way
Suite 230
Gainesville, VA 20155-3266
Phone (703) 970-2670

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2312854MAMDRegistered Nurse
0024180697VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jul 25, 2021 Accepting new patients
Inova Health Care Services CurrentSince Jul 25, 2021 Accepting new patients
Inova Health Care Services CurrentSince Jun 2, 2023 Accepting new patients
Inova Health Care Services CurrentSince Jul 25, 2021 Accepting new patients

Locations

1500 N Beauregard St
Ste 300
Alexandria, VA 22311
Phone (703) 845-1500

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

3800 Fettler Park Dr
Ste 312
Dumfries, VA 22025
Phone (571) 472-6791

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3620 Joseph Siewick Dr
Ste 400
Fairfax, VA 22033
Phone (703) 264-7801

8081 Innovation Park Dr
Ste 900
Fairfax, VA 22031
Phone (571) 472-4200

3580 Joseph Siewick Dr
Ste 206
Fairfax, VA 22033
Phone (703) 391-4500

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

7051 Heathcote Village Way
Ste 230
Gainesville, VA 20155
Phone (703) 391-4500

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

Interoperability endpoints

  • Direct secure messaging: smayo953366@soc.inova.org

Organizations & group practices 4

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 4

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": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1033769872",
    "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": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Bellamy St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021351502",
            "country_code": "US",
            "telephone_number": "617-782-8113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 N Beauregard St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223111715",
            "country_code": "US",
            "telephone_number": "703-845-1500",
            "fax_number": "703-845-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Joseph Siewick Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331709",
            "country_code": "US",
            "telephone_number": "703-391-3600",
            "fax_number": "703-391-3414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7051 Heathcote Village Way Ste 230",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "VA",
            "postal_code": "201553266",
            "country_code": "US",
            "telephone_number": "703-391-4500",
            "fax_number": "703-391-4590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4320 Seminary Rd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223041535",
            "country_code": "US",
            "telephone_number": "703-504-3000",
            "fax_number": "703-504-3388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3580 Joseph Siewick Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331764",
            "country_code": "US",
            "telephone_number": "703-391-4500",
            "fax_number": "703-391-4590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8081 Innovation Park Dr Ste 900",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314867",
            "country_code": "US",
            "telephone_number": "571-472-4200",
            "fax_number": "571-472-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYO",
        "first_name": "SAMUEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-13",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2312854",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.