Alison Beth Mantua, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110001075 Issued in VA

Practice address

8503 Arlington Blvd
Suite 310
Fairfax, VA 22031-4628

Phone

(703) 208-4200

Fax

(703) 876-1799

NPI assigned

Jan 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Alison Beth Goldfarb Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Fairfax Radiological Consultants

  • Specialist
  • Falls Church, VA
  • NPI 1114902509
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1184771677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8503 ARLINGTON BLVD",
            "address_2": "SUITE 310",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314628",
            "telephone_number": "703-208-4200",
            "fax_number": "703-876-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8503 ARLINGTON BLVD",
            "address_2": "SUITE 310",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314628",
            "telephone_number": "703-208-4200",
            "fax_number": "703-876-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTUA",
        "first_name": "ALISON",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISON",
            "last_name": "GOLDFARB",
            "middle_name": "BETH",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Max Manson
• Darlene Mansoor, M.D.
• Renu Sharaf Mansukhani, M.D.
• Diane Mantos, RN, BSN, CCM
• Mantra Mental Health PLLC
• Aileen Marie Mapalo, OT
• Maple Chiropractic & Acupuncture Clinic, LLC
• Ronica A Marable, PHD
• Alhaji Marah
• Khadijah Maraheel, PHARMACIST, PHARMD

• Medical Physician Assistant in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.