Individual provider Active NPI

Elizabeth Klaes York, PA-C

  • Physician Assistant
  • Fairfax, VA
National Provider Identifier
1164725982
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-003471 Issued in VA
Practice address
2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357
Phone
(703) 280-2841
NPI assigned
Dec 16, 2010
Last updated
Sep 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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 0110-003471 VA Primary
Surgical Physician Assistant 363AS0400X 0110-003471 VA

Addresses

Primary practice location

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357

Mailing address

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357
Phone (703) 280-2841

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110318000392 DC Practitioner - Physician Assistant 3173706850 Reassigns benefits to 1 organization
I20151211002304 VA Practitioner - Physician Assistant 3173706850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairfax Colon and Rectal Surgery PCGroup PAC ID 4385628411, 12 clinicians
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4358
Phone (703) 280-2841

3700 Joseph Siewick Dr
Fairfax, VA 22033-1738
Phone (703) 280-2841

44045 Riverside Pkwy
Suite 102
Lansdowne, VA 20176-5101
Phone (703) 280-2841

6230 Rolling Rd
Suite Ij
Springfield, VA 22152-2307
Phone (571) 565-6460

7051 Heathcote Village Way
Suite 135
Gainesville, VA 20155-3196
Phone (703) 280-2841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-003471VAMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1164725982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 PROSPERITY AVE",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314357",
            "telephone_number": "703-280-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 PROSPERITY AVE",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314357",
            "telephone_number": "703-280-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK",
        "first_name": "ELIZABETH",
        "middle_name": "KLAES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-003471",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110-003471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.