Individual provider Active NPI

Elizabeth Prevou, PA-C

  • Physician Assistant
  • Washington, DC
National Provider Identifier
1205201993
Registry record updated Dec 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA031189 Issued in DC
Practice address
1101 15TH St NW
Washington, DC 20005-5002
Phone
(202) 798-0100
NPI assigned
Dec 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA031189 DC Primary

Addresses

Primary practice location

1101 15TH St NW
Washington, DC 20005-5002

Mailing address

1101 15TH St NW
Washington, DC 20005-5002
Phone (202) 798-0100

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
I20160224000507 DC Practitioner - Physician Assistant 8921303264 Reassigns benefits to 2 organizations
I20241204002139 VA Practitioner - Physician Assistant 8921303264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Ucc LLCGroup PAC ID 7012385040, 158 clinicians

Practice addresses (Care Compare)

12493 Dillingham SQ
Lake Ridge, VA 22192-5257
Phone (571) 513-7857

1340 Old Chain Bridge Rd
Suite 101
MC Lean, VA 22101-3909
Phone (703) 893-2273

1488 Northpoint VLG Ctr
Inova Ghlth Ucc Rest
Reston, VA 20194-1190
Phone (571) 525-5850

180 Maple Ave W
Vienna, VA 22180-5727
Phone (703) 938-5300

24801 Pinebrook Rd
Suite 110
Chantilly, VA 20152-4113
Phone (703) 722-2500

3902 Wilson Blvd
Arlington, VA 22203-1953
Phone (571) 560-2648

43135 Broadlands Ctr PLZ
Suite 123
Broadlands, VA 20148-3804
Phone (571) 206-0742

6201 Centreville Rd
Suite 200
Centreville, VA 20121-2626
Phone (571) 549-8577

6206 Rolling Rd
Springfield, VA 22152-2306
Phone (571) 889-3235

6218 N Kings Hwy
Suite B
Alexandria, VA 22303-2442
Phone (571) 560-2621

7637 Linton Hall Rd
Gainesville, VA 20155-2971
Phone (703) 743-7000

9404 A Main St
Fairfax, VA 22031-4032
Phone 47027679312302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA031189DCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eprevou1443736@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.

NPI Registry JSON

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

{
    "created_epoch": "1449360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449360000000",
    "number": "1205201993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 15TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200055002",
            "telephone_number": "202-798-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 15TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200055002",
            "telephone_number": "202-798-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVOU",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-06",
        "last_updated": "2015-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA031189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.