Individual provider Active NPI

Jason A. Cooper, MD

  • Family Medicine Physician
  • Herndon, VA
National Provider Identifier
1053305102
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101054352 Issued in VA
Practice address
555 Herndon Parkway
Ste 100
Herndon, VA 20170-4828
Phone
(703) 481-1505
Fax
(703) 742-8793
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101054352 VA Primary

Addresses

Primary practice location

555 Herndon Parkway
Ste 100
Herndon, VA 20170-4828

Mailing address

555 Herndon Parkway
Ste 100
Herndon, VA 20170-4828
Phone (703) 481-1505

Other identifiers 2

IdentifierTypeStateIssuer
05622620MedicaidVA
080182902OtherVARR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcooper706409@soc.inova.org Health Information Exchange (HIE) Inova Physician Partners, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110428000560 DC Practitioner - Family Practice 6406755453 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairfax Family Practice Centers PCGroup PAC ID 4082513031, 106 clinicians

Practice addresses (Care Compare)

381 Elden St
Suite 1000
Herndon, VA 20170-4842
Phone (703) 481-1505

Hospital & facility affiliations

  • Caregivers Home Health Services, Inc Home health agency, Tysons, VA, CCN 497559
  • Reston Hospital Center Hospital, Reston, VA, CCN 490107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101054352VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jun 15, 2015 Accepting new patients
Inova Physician Partners, LLC Family Medicine CurrentSince Jun 25, 2020 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince Jun 15, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

6201 Centreville Rd
Ste 100
Centreville, VA 20121
Phone (703) 263-9600

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

3650 Joseph Siewick Dr
Ste 101
Fairfax, VA 22033
Phone (703) 391-0900

3650 Joseph Siewick Dr
Ste 400
Fairfax, VA 22033
Phone (703) 391-2020

381 Elden St
Ste 1000
Herndon, VA 20170
Phone (703) 481-1505

555 Herndon Pkwy
Ste 100
Herndon, VA 20170
Phone (703) 481-1505

115 Park St SE
Ste 300
Vienna, VA 22180
Phone (703) 255-9100

Interoperability endpoints

  • Direct secure messaging: jcooper706409@soc.inova.org

Organizations & group practices 6

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": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1053305102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 HERNDON PARKWAY",
            "address_2": "STE 100",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704828",
            "telephone_number": "703-481-1505",
            "fax_number": "703-742-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 HERNDON PARKWAY",
            "address_2": "STE 100",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704828",
            "telephone_number": "703-481-1505",
            "fax_number": "703-742-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JASON",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101054352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05622620",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080182902",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcooper706409@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "381 Elden St Ste 1000",
            "city": "Herndon",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201704842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

Verify at the official NPI Registry.