Individual provider Active NPI

Jason Pavelko, PA-C

  • Physician Assistant
  • Fairfax, VA
National Provider Identifier
1205608858
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009614 Issued in VA
Practice address
3020 Hamaker CT Ste 101a
Fairfax, VA 22031-2233
Phone
(571) 334-8651
NPI assigned
Oct 26, 2023
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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 0110009614 VA Primary

Addresses

Primary practice location

3020 Hamaker CT Ste 101a
Fairfax, VA 22031-2233

Mailing address

3020 Hamaker CT Ste 101a
Fairfax, VA 22031-2233
Phone (571) 334-8651

Other practice location 1

14800 Lee Hwy
Gainesville, VA 20155-1842
Phone (703) 743-7017

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)

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
I20240417004283 DC Practitioner - Physician Assistant 3870932247 Reassigns benefits to 1 organization
I20240424003786 VA Practitioner - Physician Assistant 3870932247 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC CurrentSince Mar 13, 2024 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Mar 13, 2024 Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

14800 Lee Hwy
Gainesville, VA 20155
Phone (703) 743-7017

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

Interoperability endpoints

  • Direct secure messaging: vaexchange@patientfirstclinics.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1205608858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT STE 101A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312233",
            "telephone_number": "571-334-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT STE 101A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312233",
            "telephone_number": "571-334-8651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14800 Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "VA",
            "postal_code": "201551842",
            "country_code": "US",
            "telephone_number": "703-743-7017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVELKO",
        "first_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-26",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "14800 Lee Hwy",
            "city": "Gainesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201551842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.