Individual provider Active NPI

Pegah Barker, PA-C

  • Physician Assistant
  • Arlington, VA
National Provider Identifier
1104381060
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-006553 Issued in VA
Practice address
2501 N Glebe Rd
Arlington, VA 22207-3558
Phone
(703) 841-1290
NPI assigned
Feb 5, 2019
Last updated
Apr 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0007442 MD
Physician Assistant 363A00000X 0110-006553 VA Primary

Addresses

Primary practice location

2501 N Glebe Rd
Arlington, VA 22207-3558

Mailing address

6218 Montrose Rd Ste 303
Rockville, MD 20852-4119
Phone (703) 841-1290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190416002726 DC Practitioner - Physician Assistant 7315288578 Reassigns benefits to 1 organization
I20200728002442 MD Practitioner - Physician Assistant 7315288578 Reassigns benefits to 2 organizations
I20230318000076 VA Practitioner - Physician Assistant 7315288578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Verum Cutis Dermatology PLLCGroup PAC ID 0244588176, 5 clinicians

Practice addresses (Care Compare)

44110 Ashburn Shopping PLZ
Unit 237
Ashburn, VA 20147-7912
Phone (703) 687-3105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0007442MDMDPhysician Assistant
0110-006553VAMDPhysician Assistant

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1104381060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6218 MONTROSE RD STE 303",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524119",
            "telephone_number": "703-841-1290",
            "fax_number": "301-255-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N GLEBE RD",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222073558",
            "telephone_number": "703-841-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "PEGAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007442",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-006553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.