Individual provider Active NPI

Jesse Manuel Ventoso, DC

  • Chiropractor
  • Fairfax, VA
National Provider Identifier
1316555873
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557858 Issued in VA
Practice address
11350 Random Hills Rd Ste 300
Fairfax, VA 22030-7421
Phone
(703) 373-7113
NPI assigned
Jul 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557858 VA Primary

Addresses

Primary practice location

11350 Random Hills Rd Ste 300
Fairfax, VA 22030-7421

Mailing address

11350 Random Hills Rd Ste 300
Fairfax, VA 22030-7421
Phone (703) 373-7113

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drjesse@thenestchiro.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223002128 DC Practitioner - Chiropractic 9335676857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee DC Active Family WellnessGroup PAC ID 7012377492, 6 clinicians

Practice addresses (Care Compare)

11350 Random Hills Rd
Suite 300
Fairfax, VA 22030-7421
Phone (703) 373-7113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104557858VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Family Wellness PLLC Chiropractor CurrentSince Dec 1, 2024 Accepting new patients

Locations

11350 Random Hills Rd
Ste 300
Fairfax, VA 22030
Phone (703) 373-7113

Organizations & group practices 1

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": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1316555873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 RANDOM HILLS RD STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307421",
            "telephone_number": "703-373-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 RANDOM HILLS RD STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307421",
            "telephone_number": "703-373-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTOSO",
        "first_name": "JESSE",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drjesse@thenestchiro.com",
            "affiliation": "N",
            "address_1": "341 Smith Rd",
            "city": "Parsippany",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070542805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.