Individual provider Active NPI

Jessica Wertz, DO

  • Sports Medicine (Family Medicine) Physician
  • Fairfax, VA
National Provider Identifier
1104080050
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
0102204185 Issued in VA
Practice address
8501 Arlington Blvd Ste 200
Fairfax, VA 22031-4625
Phone
(703) 204-2626
Fax
(703) 205-7324
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X H0076278 MD
Sports Medicine (Family Medicine) Physician 207QS0010X 0102204185 VA Primary

Addresses

Primary practice location

8501 Arlington Blvd Ste 200
Fairfax, VA 22031-4625

Mailing address

844 Washington Rd
Suite 102
Westminster, MD 21157-6664
Phone (410) 871-0088

Other practice location 1

844 Washington Rd
Suite 102
Westminster, MD 21157-6664
Phone (410) 871-0088

Other identifiers 1

IdentifierTypeStateIssuer
068733200MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwertz179834@soc.inova.org Health Information Exchange (HIE) Inova Health Care Services

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150623002391 DC Practitioner - Internal Medicine 8325204365 Reassigns benefits to 1 organization
I20151005000216 VA Practitioner - Internal Medicine 8325204365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

8100 Innovation Park Dr
Fairfax, VA 22031-4870
Phone (571) 472-0321

Hospital & facility affiliations

  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
H0076278MDMDSports Medicine (Family Medicine) Physician
0102204185VAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jul 6, 2015 Accepting new patients
Inova Health Care Services CurrentSince Jul 6, 2015 Accepting new patients

Locations

8100 Innovation Park Dr
#110
Fairfax, VA 22031
Phone (703) 970-6464

8501 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 970-6464

8100 Innovation Park Dr
Ste 110
Fairfax, VA 22031
Phone (571) 472-6464

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • Direct secure messaging: jwertz179834@soc.inova.org

Organizations & group practices 2

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1104080050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576664",
            "telephone_number": "410-871-0088",
            "fax_number": "410-871-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 ARLINGTON BLVD STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314625",
            "telephone_number": "703-204-2626",
            "fax_number": "703-205-7324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "844 Washington Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211576664",
            "country_code": "US",
            "telephone_number": "410-871-0088",
            "fax_number": "410-871-0083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WERTZ",
        "first_name": "JESSICA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MD",
            "license": "H0076278",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102204185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068733200",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwertz179834@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8100 Innovation Park Dr # 110",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.