Ian Jacob Henry

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1850 Town Center Pkwy
Reston, VA 20190-3298

Phone

(703) 689-9000

NPI assigned

Jan 3, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Commonwealth Critical Care LLCGroup PAC ID 4284909029, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043
• Reston Hospital Center Hospital, Reston, VA, CCN 490107

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Commonwealth Critical Care LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Alexandria, VA
  • NPI 1891210035
  Medicare reassignment Care Compare group
• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  DC, VA

  Medicare reassignment Care Compare group
• Commonwealth Critical Care LLC

  • Nurse Practitioner
  • Leesburg, VA
  • NPI 1447829163

  Physician Assistant

  NPD (past)

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

• Inova Health Care Services

  • Psychiatric Hospital Unit
  • Leesburg, VA
  • NPI 1285786228
  Care Compare affiliation
• Inova Health Care Services

  • General Acute Care Hospital
  • Leesburg, VA
  • NPI 1376564302
  Care Compare affiliation
• Reston Hospital Center LLC

  • General Acute Care Hospital
  • Reston, VA
  • NPI 1053363853
  Care Compare affiliation

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1043971047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 FORT EVANS RD SE APT A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754142",
            "telephone_number": "703-371-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903298",
            "telephone_number": "703-689-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "IAN",
        "middle_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosella Marie Helean
• Scott Alan Helgesen, PA-C
• Justin Carl Hemmer, DPT
• Marina Hendrickson
• Heather Kilbride Henig, MD
• Melissa Hernandez-Dobkin
• Kelly Davis Hernandez, FNP
• Paolo Alexander Hernandez, M.D.
• Herndon Modern Dentistry, PC
• Tania Joseline Herrera Umanzor, LCSW

• Physician Assistant in Reston, VA
• Providers in Reston, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.