Individual provider Active NPI

Jean Al Donet Mostacero, MD

  • Gastroenterology Physician
  • Fairfax, VA
National Provider Identifier
1245593292
Registry record updated Dec 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101276282 Issued in VA
Practice address
8081 Innovation Park Dr Ste 301
Fairfax, VA 22031-4867
Phone
(571) 472-6431
Fax
(571) 665-6826
NPI assigned
Jun 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A163167 CA
Gastroenterology Physician 207RG0100X 0101276282 VA Primary

Addresses

Primary practice location

8081 Innovation Park Dr Ste 301
Fairfax, VA 22031-4867

Mailing address

8081 Innovation Park Dr Ste 301
Fairfax, VA 22031-4867
Phone (571) 472-6431

Other practice location 1

2615 E Clinton Ave
Fresno, CA 93703-2223
Phone (559) 228-5300

Other practice location 2

2335 E Kashian Ln Ste 280
Fresno, CA 93701-2211
Phone (559) 320-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230216000348 VA Practitioner - GastroenterologyPractitioner - Internal Medicine 4981952249 Reassigns benefits to 1 organization
I20230216000470 DC Practitioner - GastroenterologyPractitioner - Internal Medicine 4981952249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

4320 Seminary Rd
Alexandria, VA 22304-1535

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

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy73
Upper gastrointestinal (GI) endoscopy for acid reflux49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A163167CAMDGastroenterology Physician
0101276282VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Dec 12, 2022 Accepting new patients

Locations

8081 Innovation Park Dr
Ste 301
Fairfax, VA 22031
Phone (571) 472-6431

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

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

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

Interoperability endpoints

  • Direct secure messaging: jdonet1101790@soc.inova.org

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 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": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670630400000",
    "number": "1245593292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR STE 301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-6431",
            "fax_number": "571-665-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR STE 301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-6431",
            "fax_number": "571-665-6826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 E Clinton Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937032223",
            "country_code": "US",
            "telephone_number": "559-228-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2335 E Kashian Ln Ste 280",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937012211",
            "country_code": "US",
            "telephone_number": "559-320-1090",
            "fax_number": "559-320-0331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONET MOSTACERO",
        "first_name": "JEAN",
        "middle_name": "AL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-24",
        "last_updated": "2022-12-10",
        "certification_date": "2022-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A163167",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101276282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.