Individual provider Active NPI

Shoshana D Katz, PA-C

  • Physician Assistant
  • Fairfax, VA
National Provider Identifier
1114263613
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01104098 Issued in VA
Practice address
3031 Javier Rd Ste 210
Fairfax, VA 22031-4638
Phone
(703) 914-8000
Fax
(703) 914-0064
NPI assigned
Jan 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 01104098 VA Primary

Addresses

Primary practice location

3031 Javier Rd Ste 210
Fairfax, VA 22031-4638

Mailing address

3031 Javier Rd Ste 210
Fairfax, VA 22031-4638
Phone (703) 914-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20131016000625 VA Practitioner - Physician Assistant 3971737412 Reassigns benefits to 1 organization
I20131107000116 DC Practitioner - Physician Assistant 3971737412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifestream Health CenterGroup PAC ID 4284870072, 6 clinicians

Practice addresses (Care Compare)

4000 Mitchellville Rd
Suite B322
Bowie, MD 20716-3176
Phone (301) 860-0305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01104098VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis Care Center PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Physical Medicine Associates LTD Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20459/brand/1/csg/1/fhir/r4
  • Direct secure messaging: shoshana.katz.1@20459.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BBIBAA

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1114263613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 JAVIER RD STE 210",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314638",
            "telephone_number": "703-914-8000",
            "fax_number": "703-914-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 JAVIER RD STE 210",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314638",
            "telephone_number": "703-914-8000",
            "fax_number": "703-914-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "SHOSHANA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "01104098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.