Individual provider Active NPI

Angela Ann Fasanella, FNP-BC

  • Family Nurse Practitioner
  • Kent, WA
National Provider Identifier
1043768682
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP.AP.61153619-NP Issued in WA
Practice address
219 State Ave N # 200
Kent, WA 98030-4543
Phone
(253) 372-7849
Fax
(253) 372-7844
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173959 VA
Family Nurse Practitioner 363LF0000X ARNP.AP.61153619-NP WA Primary

Addresses

Primary practice location

219 State Ave N # 200
Kent, WA 98030-4543

Mailing address

PO Box 5299
Ms: 820-5-Pco
Tacoma, WA 98415-0299

Other practice location 1

17739 Main St Ste 110
Dumfries, VA 22026-3256
Phone (703) 574-3415

Other practice location 2

14904 Jefferson Davis Hwy Ste 208
Woodbridge, VA 22191
Phone (703) 224-9999

Other practice location 3

9009 Silverbrook Rd
Fairfax Station, VA 22039-2607
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, WA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190401000093 VA Practitioner - Nurse Practitioner 9234427709 Reassigns benefits to 5 organizations
I20201116002016 DC Practitioner - Nurse Practitioner 9234427709 Reassigns benefits to 4 organizations
I20260623003944 WA Practitioner - Nurse Practitioner 9234427709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

16830 Dumfries Rd
Suite 150
Dumfries, VA 22025-2056
Phone (703) 574-3415

Hospital & facility affiliations

  • Sentara Northern Virginia Medical Center Hospital, Woodbridge, VA, CCN 490113

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Greatest Care LLC Family CurrentSince Jun 23, 2024 Accepting new patients
Roanoke Valley Healthcare Partners, LLC CurrentSince Mar 24, 2024 Accepting new patients
Sentara Medical Group CurrentSince Sep 1, 2024 Accepting new patients
Express Healthcare, LLC CurrentSince Aug 10, 2021 Accepting new patients
Minuteclinic Diagnostic of Virginia LLC Family CurrentSince Apr 25, 2024 Accepting new patients
Blue Ridge Healthcare Partners, LLC Past Accepting new patients
Short Pump Family Care, LLC PastSince Feb 1, 2016 Accepting new patients
Express Healthcare, LLC Past Accepting new patients

Locations

6201 Greenbelt Rd
Ste M16
Berwyn Heights, MD 20740
Phone (301) 441-4400

6201 Greenbelt Rd
Ste M15
Berwyn Heights, MD 20740
Phone (301) 441-1112

1636 Belle View Blvd
Alexandria, VA 22307
Phone (703) 703-7687

9276 Old Keene Mill Rd
Burke, VA 22015
Phone (571) 516-3116

17739 Main St
Ste 110
Dumfries, VA 22026
Phone (703) 574-3415

16830 Dumfries Rd
Ste 150
Dumfries, VA 22025
Phone (703) 574-3415

9009 Silverbrook Rd
Fairfax Station, VA 22039
Phone (703) 493-8531

6305 Castle Pl
Ste 2D
Falls Church, VA 22044
Phone (703) 344-8355

19305 Ruby Dr
Leesburg, VA 20176
Phone (571) 333-5918

12731 Stone Village Way
Midlothian, VA 23113
Phone (804) 379-1500

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1119 N Military Hwy
Ste 300
Norfolk, VA 23502
Phone (757) 224-3004

602 Brandon Ave SW
Ste 222
Roanoke, VA 24015
Phone (540) 774-0000

1013 University Blvd
Ste 270
Suffolk, VA 23435
Phone (757) 335-4755

1980 Gallows Rd
Ste 100
Vienna, VA 22182
Phone (703) 436-0203

1721 Laskin Rd
Ste 101
Virginia Beach, VA 23454
Phone (757) 240-3500

14087 Richmond Hwy
Ste 101
Woodbridge, VA 22191
Phone (571) 300-8000

4101 Cheshire Station Plz
Ste 500
Woodbridge, VA 22193
Phone (571) 374-1234

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHIDAD/Endpoint/BHIDAD

Organizations & group practices 10

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 1

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1043768682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5299",
            "address_2": "MS: 820-5-PCO",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 STATE AVE N # 200",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304543",
            "telephone_number": "253-372-7849",
            "fax_number": "253-372-7844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17739 Main St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Dumfries",
            "state": "VA",
            "postal_code": "220263256",
            "country_code": "US",
            "telephone_number": "703-574-3415",
            "fax_number": "757-452-5768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14904 Jefferson Davis Hwy Ste 208",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "22191",
            "country_code": "US",
            "telephone_number": "703-224-9999",
            "fax_number": "571-384-6702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9009 Silverbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Fairfax Station",
            "state": "VA",
            "postal_code": "220392607",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASANELLA",
        "first_name": "ANGELA",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173959",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "ARNP.AP.61153619-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.