Individual provider Active NPI

Yuliya Matsova, NP

  • Nurse Practitioner
  • Kensington, MD
National Provider Identifier
1184241614
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AC003234 Issued in MD
Practice address
10605 Concord St
Kensington, MD 20895-2504
Phone
(301) 942-9833
NPI assigned
Jul 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 0024179619 VA
Nurse Practitioner 363L00000X AC003234 MD Primary
Adult Health Nurse Practitioner 363LA2200X 0024179619 VA
Gerontology Nurse Practitioner 363LG0600X 0024179619 VA
Nurse Practitioner 363L00000X 0024179619 VA

Addresses

Primary practice location

10605 Concord St
Kensington, MD 20895-2504

Mailing address

4308 Sutler Hill SQ
Fairfax, VA 22033-4256
Phone (440) 596-9804

Other practice location 1

4308 Sutler Hill Sq
Fairfax, VA 22033-4256
Phone (440) 596-9804

Other identifiers 1

IdentifierTypeStateIssuer
30017548480002MedicaidVA

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
I20210114001797 DC Practitioner - Nurse Practitioner 0143633057 Reassigns benefits to 1 organization
I20230925000134 VA Practitioner - Nurse Practitioner 0143633057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (877) 511-4625

3300 Gallows Rd
Falls Church, VA 22042-3307

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 771-2960

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AC003234MDMDNurse Practitioner
0024179619VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Oct 14, 2023 Accepting new patients
Benham Physician Services LLC Nurse Practitioner CurrentSince Nov 3, 2025 Accepting new patients
Inova Health Care Services CurrentSince Oct 14, 2023 Accepting new patients

Locations

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • Direct secure messaging: ymatsova1088125@soc.inova.org

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.

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": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1184241614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 SUTLER HILL SQ",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334256",
            "telephone_number": "440-596-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 CONCORD ST",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952504",
            "telephone_number": "301-942-9833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4308 Sutler Hill Sq",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220334256",
            "country_code": "US",
            "telephone_number": "440-596-9804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATSOVA",
        "first_name": "YULIYA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024179619",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "AC003234",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024179619",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024179619",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024179619",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017548480002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kensington, MD

Sources for this page

Verify at the official NPI Registry.