Alexa Roberge, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110010521 Issued in VA

Practice address

2200 Opitz Blvd Ste 100
Woodbridge, VA 22191-3342

Phone

(703) 492-4140

NPI assigned

Nov 13, 2024

Last updated

Nov 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin and Laser Surgery CenterGroup PAC ID 4082788302, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Skin and Laser Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Vienna, VA
  • NPI 1720277932

  DC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1083438220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 OPITZ BLVD STE 100",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 OPITZ BLVD STE 100",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913342",
            "telephone_number": "703-492-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1359 Beverly Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221013666",
            "country_code": "US",
            "telephone_number": "703-893-1114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERGE",
        "first_name": "ALEXA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolie Rivenbark, RN, PMHNP-BC
• Kathy Rivera
• Kristina Rivera, FNP-BC
• Luisa Rivera
• Komal Rizwan II
• James Curtis Roberson III, MD
• Robert a. Cohen, M.D., P.C.
• Robert E. Schell, D.D.S., P.C.
• Camicha Robertson
• Richard George Robinson, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.