Individual provider Active NPI

Paul M Corbett, CRNA

  • Certified Registered Nurse Anesthetist
  • Fairfax, VA
National Provider Identifier
1053461889
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024171123 Issued in VA
Practice address
3998 Fair Ridge Drive
Suite 320
Fairfax, VA 22033-2921
Phone
(703) 295-9360
Fax
(703) 295-9369
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 157355 NC
Certified Registered Nurse Anesthetist 367500000X 072157 NC
Certified Registered Nurse Anesthetist 367500000X 0024171123 VA Primary

Addresses

Primary practice location

3998 Fair Ridge Drive
Suite 320
Fairfax, VA 22033-2921

Mailing address

PO Box 37090
Baltimore, MD 21297-3090
Phone (703) 295-9360

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidVA
5903562MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, WV, MD4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20131028001235 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709833486 Reassigns benefits to 2 organizations
I20131030000922 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709833486 Reassigns benefits to 2 organizations
I20150331001322 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709833486 Reassigns benefits to 1 organization
I20181108002002 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709833486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
157355NCMDRegistered Nurse
072157NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine Associates, LTD CurrentSince Oct 1, 2019 Accepting new patients
Physical Medicine Associates, LTD CurrentSince Oct 1, 2019 Accepting new patients
Clinical Colleagues Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 10, 2015 Accepting new patients
Center for Pain Management, LLC CurrentSince Oct 1, 2019 Accepting new patients
ASC Development Company, LLC Past Accepting new patients
ASC Development Company, LLC Past Accepting new patients
ASC Development Company, LLC Past Accepting new patients
ASC Development Company, LLC Past Accepting new patients
East Carolina Anesthesia Associates, PLLC Registered Nurse PastSince Jan 1, 2006 Accepting new patients
ASC Development Company, LLC Past Accepting new patients
ASC Development Company, LLC Past Accepting new patients
ASC Development Company, LLC Past Accepting new patients
Surgery Center of Central Virginia Inc. Past Accepting new patients
ASC Development Company, LLC Past Accepting new patients
ASC Development Company, LLC Past Accepting new patients
ASC Development Company LLC Past Accepting new patients
NSPC Surgery Center of Maryland LLC Past Accepting new patients

Locations (25 of 27)

510 Upper Chesapeake Dr
Ste 415
Bel Air, MD 21014
Phone (443) 643-3000

16900 Science Dr
Ste 100
Bowie, MD 20715
Phone (301) 464-7008

7120 Minstrel Way
Ste 106
Columbia, MD 21045
Phone (410) 290-9191

9151 Rumsey Rd
Ste 150
Columbia, MD 21045
Phone (443) 583-7958

75 Thomas Johnson Dr
Ste C
Frederick, MD 21702
Phone (301) 620-0012

19735 Germantown Rd
Ste 360
Germantown, MD 20874
Phone (301) 528-2810

1600 Crain Hwy S
Ste 301
Glen Burnie, MD 21061
Phone (410) 760-1400

1150 Professional Ct
Ste P
Hagerstown, MD 21740
Phone (301) 665-9696

11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071

6710 Oxon Hill Rd
Ste 550
Oxon Hill, MD 20745
Phone (301) 485-7400

1838 Greene Tree Rd
Ste 150
Pikesville, MD 21208
Phone (301) 881-7246

11921 Rockville Pike
Ste 505
Rockville, MD 20852
Phone (301) 881-7246

6820 Hospital Dr
Ste 302
Rosedale, MD 21237
Phone (410) 682-2823

3460 Old Washington Rd
Ste 300
Waldorf, MD 20602
Phone (301) 645-1523

5010 Regency Pl
Ste 202A
White Plains, MD 20695
Phone (301) 645-1523

5010 Regency Pl
Ste 202B
White Plains, MD 20695
Phone (301) 645-1523

6355 Walker Ln
Ste 507
Alexandria, VA 22310
Phone (703) 738-4332

3620 Joseph Siewick Dr
Ste 410
Fairfax, VA 22033

5213 Hickory Park Dr
Ste B
Glen Allen, VA 23059
Phone (804) 270-7262

1750 Tysons Blvd
Ste 120
McLean, VA 22102
Phone (703) 556-9155

1750 Tysons Blvd
Ste 210
McLean, VA 22102

1420 Spring Hill Rd
Ste 210
McLean, VA 22102
Phone (703) 738-4342

525 Amherst St
Ste 104
Winchester, VA 22601
Phone (540) 662-4263

14605 Potomac Branch Dr
Ste 100
Woodbridge, VA 22191
Phone (703) 738-4371

500 Cherry St
Bluefield, WV 24701
Phone (304) 324-2614

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1053461889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37090",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973090",
            "telephone_number": "703-295-9360",
            "fax_number": "703-295-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DRIVE",
            "address_2": "SUITE 320",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-295-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "PAUL",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "157355",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "072157",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024171123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903562",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.