Active NPI
Kristen Qumsieh, PA-C
- Physician Assistant
- Fredericksburg, VA
National Provider Identifier
1265755094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110003252
- Practice address
- 1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453 - Phone
- (540) 741-1793
- NPI assigned
- Mar 8, 2010
- Last updated
- Jun 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110003252 | VA | Primary |
Addresses
Primary practice location
1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Mailing address
820 Springer Dr
Lombard, IL 60148-6413
Phone (708) 634-4602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FL-I Medical Services LLC | Physician Assistant | Current | Accepting new patients |
| FL-I Medical Services, LLC | Physician Assistant | Current | Accepting new patients |
| MWHC Urgent Care LLC | Past | Accepting new patients |
Locations
1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Fredericksburg, VA
- NPI 1396779153
-
- Physician Assistant
- Haines City, FL
- NPI 1285356790
-
dba Mary Washington Urgent Care
- Urgent Care Clinic/Center
- King George, VA
- NPI 1306405709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622678400000",
"number": "1265755094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 SPRINGER DR",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601486413",
"telephone_number": "708-634-4602",
"fax_number": "630-495-1770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 SAM PERRY BLVD",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224014453",
"telephone_number": "540-741-1793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUMSIEH",
"first_name": "KRISTEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-08",
"last_updated": "2021-06-03",
"certification_date": "2021-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110003252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.