Individual provider Active NPI

Alfred J. Pacifico, P.A-C

  • Physician Assistant
  • Potomac Falls, VA
National Provider Identifier
1194779355
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-840459 Issued in VA
Practice address
20796 Eskridge CT
Potomac Falls, VA 20165-7735
Phone
(703) 727-7773
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-840459 VA Primary
Physician Assistant 363A00000X 003990-1 NY
Physician Assistant 363A00000X C0001501 MD

Addresses

Primary practice location

20796 Eskridge CT
Potomac Falls, VA 20165-7735

Mailing address

20796 Eskridge CT
Potomac Falls, VA 20165-7735
Phone (703) 727-7773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080429000161 VA Practitioner - Physician Assistant 6709964943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.67 of 100Reported as group
Quality
90.2
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0001501MDMDPhysician Assistant
003990-1NYMDPhysician Assistant
0110-840459VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Critical Care Services,L.L.C. PastSince Mar 1, 2013 Accepting new patients
Emergency Medicine Associates P.a., P.C. Past Accepting new patients
Emergency Medicine Associates Past Accepting new patients
Commonwealth Emergency Physicians PC Physician Assistant PastSince Apr 17, 2020 Accepting new patients

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1194779355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20796 ESKRIDGE CT",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201657735",
            "telephone_number": "703-727-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20796 ESKRIDGE CT",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201657735",
            "telephone_number": "703-727-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACIFICO",
        "first_name": "ALFRED",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-840459",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003990-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac Falls, VA

Sources for this page

Verify at the official NPI Registry.