Pediatricare of Northern Virginia, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRICARE OF NORTHERN VIRGINIA, P.C.

Practice address

8640 Sudley Rd
Suite 306
Manassas, VA 20110-4420

Phone

(703) 330-3939

Fax

(703) 331-0959

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Frank James Giancola, MDNPI 1831190826

Title

President

Phone

(703) 330-3939

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frank James Giancola, MD

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1831190826
  Medicare reassignment NPD Authorized official
• Chiquitia Jenee Anderson, M.D.

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1205037959
  Medicare reassignment NPD
• Ingrid Denise Johnson, MD

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1851311898
  Medicare reassignment NPD
• David Harold Katz, MD

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1598785529
  Medicare reassignment NPD
• Sarah Jeanette Long, CPNP

  • Pediatric Nurse Practitioner
  • Manassas, VA
  • NPI 1982865218
  Medicare reassignment NPD
• Raydel Miranda, ARNP-BC

  • Family Nurse Practitioner
  • Turlock, CA
  • NPI 1770856890

  VA

  Medicare reassignment NPD
• Tina Nguyen, MD

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1740840560

  VA

  Medicare reassignment NPD
• Manuel R Tamondong Jr., M.D.

  • Pediatrics Physician
  • Montezuma, GA
  • NPI 1588729388

  VA

  Medicare reassignment NPD
• Jillian Rae Caminske, NURSE PRACTITIONER

  • Pediatric Nurse Practitioner
  • Manassas, VA
  • NPI 1912779034
  NPD
• Jessica Field Hamman, CPNP

  • Pediatric Nurse Practitioner
  • Manassas, VA
  • NPI 1619263803
  NPD (past)
• Amy Brozick Jacobson, CPNP-BC

  • Pediatric Nurse Practitioner
  • Reston, VA
  • NPI 1558765636

  Pediatrics

  NPD (past)
• Elena Mercedes Shea, MD

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1235390097
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104994623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 SUDLEY ROAD",
            "address_2": "SUITE 306",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104404",
            "telephone_number": "703-330-3939",
            "fax_number": "703-331-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 SUDLEY RD",
            "address_2": "SUITE 306",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104420",
            "telephone_number": "703-330-3939",
            "fax_number": "703-331-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICARE OF NORTHERN VIRGINIA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GIANCOLA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-330-3939",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith C Pederson, MD
• Pediatric Associates of Manassas
• Pediatric Associates of Northern Virginia, P.C.
• Pediatric Associates of Prince William County, LLC
• Pediatric Practice,PC
• Pediatrix Medical Group PC
• Kevin Edward Peltier I, MD
• Nicole Penke, MD
• Anna Penna, MD
• Victoria Pennant, LPC

• Pediatrics Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.