Individual provider Active NPI

Monique Chinyere Nwala, MPAS, PA-C

  • Physician Assistant
  • Herndon, VA
National Provider Identifier
1245704766
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1141 Elden St Ste 300
Herndon, VA 20170-5572
Phone
(703) 840-4705
NPI assigned
Jan 17, 2019
Last updated
May 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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 Primary

Addresses

Primary practice location

1141 Elden St Ste 300
Herndon, VA 20170-5572

Mailing address

703 Andover CT
Chesapeake, VA 23322-7387

Other practice location 1

110 Kingsley Ln Ste 312
Norfolk, VA 23505-4618
Phone (757) 889-4383

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
I20190319002927 VA Practitioner - Physician Assistant 1456691922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loudoun Community Health CenterGroup PAC ID 5193822930, 11 clinicians

Practice addresses (Care Compare)

1141 Elden St
Suite 300
Herndon, VA 20170-5549
Phone (703) 481-8160

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Community Health Center CurrentSince Jul 27, 2021 Accepting new patients
Loudoun Community Health Center CurrentSince Jul 27, 2021 Accepting new patients

Locations

1141 Elden St
Ste 300
Herndon, VA 20170
Phone (703) 481-8160

13800 Wall Rd
Ste 55
Herndon, VA 20171

163 Fort Evans Rd NE
Leesburg, VA 20176
Phone (703) 433-2000

11484 Washington Plz W
Ste 300
Reston, VA 20190
Phone (703) 689-2180

21641 Ridgetop Cir
Ste 107
Sterling, VA 20166
Phone (703) 475-7595

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.

Hospital & facility affiliations 1

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1245704766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 ANDOVER CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233227387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 ELDEN ST STE 300",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705572",
            "telephone_number": "703-840-4705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Kingsley Ln Ste 312",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235054618",
            "country_code": "US",
            "telephone_number": "757-889-4383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWALA",
        "first_name": "MONIQUE",
        "middle_name": "CHINYERE",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

Verify at the official NPI Registry.