Individual provider Active NPI

Rachel Kokal, PA-C

  • Medical Physician Assistant
  • Fairfax, VA
National Provider Identifier
1144644774
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110-004473 Issued in VA
Practice address
3025 Hamaker CT
Suite 300
Fairfax, VA 22031-2237
Phone
(703) 849-8036
Fax
(703) 204-3448
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110-004473 VA Primary

Addresses

Primary practice location

3025 Hamaker CT
Suite 300
Fairfax, VA 22031-2237

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210727000617 MD Practitioner - Physician Assistant 0648546846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derm Associates LLCGroup PAC ID 4688653306, 44 clinicians

Practice addresses (Care Compare)

71 Old Mill Bottom Rd N
Suite 300
Annapolis, MD 21409-5473
Phone (301) 681-7000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-004473VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Annapolis Dermatology Center, PA PastSince Jan 11, 1999 Accepting new patients
Ramin Farboud MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rkokal@usdp7.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144644774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9035",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 HAMAKER CT",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312237",
            "telephone_number": "703-849-8036",
            "fax_number": "703-204-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKAL",
        "first_name": "RACHEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110-004473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.