Min Jin Jung Detrick, PA-C
Individual provider Active NPI Physician Assistant · Tysons, VA
NPI 1285884007 · NPPES record last updated Mar 28, 2024
Key facts
- NPI
- 1285884007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0110003714 (VA)
- Practice address
- 8100 Boone Blvd Ste 700
Tysons, VA 22182-2683 - Phone
- (703) 531-2269
- NPI assigned
- Sep 29, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 27
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Inova Health Care Services
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
8503 Arlington Blvd
Fairfax, VA 22031-4628
Phone (703) 970-2670
Hospital & facility affiliations
- Inova Fairfax Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.36 of 100
- Quality
- 73.03
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.49
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DC, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130320000596 | DC | Practitioner - Physician Assistant | 2961570296 | Reassigns benefits to 2 organizations |
| I20240420000073 | VA | Practitioner - Physician Assistant | 2961570296 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-01553 | NC | MD | Physician Assistant |
| 0110003714 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inova Health Care Services | Current |
Accepting new patients | |
| Inova Health Care Services | Current |
Accepting new patients | |
| Homer Curtiss Merrick III MD Dba H Curtiss Merrick MD | Past | Accepting new patients | |
| Sea Breeze Family Practice P a | Past | Accepting new patients | |
| H Curtiss Merrick MD PA | Past | Accepting new patients |
Locations
3022 Williams Dr
Ste 300
Fairfax, VA 22031
Phone (703) 573-9800
3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037
8503 Arlington Blvd
Fairfax, VA 22031
Phone (703) 970-2670
3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395
224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894
8100 Boone Blvd
Ste 700
Vienna, VA 22182
Phone (571) 423-5699
Interoperability endpoints
- mdetrick65917@soc.inova.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-01553 | NC | |
| Physician Assistant | 363A00000X | 0110003714 | VA | Yes |
Addresses
Primary practice location
8100 Boone Blvd Ste 700
Tysons, VA 22182-2683
Mailing address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001
Other practice location 1
3022 Williams Dr
300
Fairfax, VA 22031-4600
Phone (703) 573-9800
Other practice location 2
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mdetrick65917@soc.inova.org | Health Information Exchange (HIE) | Inova Health Care Services |
Other providers in Tysons, VA
- Fotini Chrisopoulos
- Daniel Chun
- Connect N Care ABA VA LLC
- Dental Implant Specialists of Virginia, PC
- Sameer M Deshmukh
- Dua Consultants LLC
- Sheliya Fields
- Devika Fiorillo
- Golden Agers LLC
- Grace Path Wellness Center LLC
All providers in Tysons, VA · Physician Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.