Individual provider Active NPI

Mildred J Medrano, CRNP-FNP

  • Family Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1295253102
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174865 Issued in VA
Practice address
9229 Arlington Arlington Blvd.
Fairfax, VA 22031
Phone
(573) 408-0228
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024174865 VA Primary

Addresses

Primary practice location

9229 Arlington Arlington Blvd.
Fairfax, VA 22031

Mailing address

9906 Edgewater Ter
Fort Washington, MD 20744-5758
Phone (573) 408-0228

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
I20171113002357 DC Practitioner - Nurse Practitioner 2365708021 Reassigns benefits to 2 organizations
I20171129000260 VA Practitioner - Nurse Practitioner 2365708021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.76 of 100Reported as group
Quality
79.46
Improvement activities
40
Cost
66.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024174865VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Healthcare Services LLC CurrentSince Jan 1, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

12380 Plaza Dr
Parma, OH 44130
Phone (216) 898-8444

4315 Chain Bridge Rd
Fairfax, VA 22030
Phone (703) 205-9792

6106 Health Center Ln
Fredericksburg, VA 22407
Phone (540) 785-1103

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1295253102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9906 EDGEWATER TER",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445758",
            "telephone_number": "573-408-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9229 ARLINGTON ARLINGTON BLVD.",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "573-408-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "MILDRED",
        "middle_name": "J",
        "credential": "CRNP-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.