Individual provider Active NPI

Rubeena Vincent, FNP-C

  • Family Nurse Practitioner
  • Annandale, VA
National Provider Identifier
1316580954
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024178062 Issued in VA
Practice address
8508 Queen Elizabeth Blvd
Annandale, VA 22003-4308
Phone
(732) 986-3795
NPI assigned
Oct 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 0024178062 VA Primary

Addresses

Primary practice location

8508 Queen Elizabeth Blvd
Annandale, VA 22003-4308

Mailing address

8508 Queen Elizabeth Blvd
Annandale, VA 22003-4308

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL chicago INTEGRATED REHAB CONSULTANTS LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20200103001796 MD Practitioner - Nurse Practitioner 7517391220 Reassigns benefits to 2 organizations
I20200125000137 DC Practitioner - Nurse Practitioner 7517391220 Reassigns benefits to 1 organization
I20221003001022 VA Practitioner - Nurse Practitioner 7517391220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Physiatry Consultants LLCGroup PAC ID 5698130771, 7 clinicians

Practice addresses (Care Compare)

14906 Richmond Hwy
Woodbridge, VA 22191-4016
Phone (732) 986-3795

8508 Queen Elizabeth Blvd
Annandale, VA 22003-4308
Phone (732) 986-3795

Merit-based Incentive Payment System (MIPS)

Final score
17.22 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
57.41

Merit-based Incentive Payment System (MIPS)

Final score
79.28 of 100Reported as group
Quality
73.83
Improvement activities
40
Cost
45.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024178062VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kinetic Medical Group Family CurrentSince Apr 1, 2022 Accepting new patients
Genesis Physiatry Consultants LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

144 Washington Rd
Edgewater, MD 21037
Phone (410) 956-5000

3320 Benson Ave
Halethorpe, MD 21227
Phone (410) 644-7100

14906 Richmond Hwy
Woodbridge, VA 22191
Phone (609) 335-6595

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.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1316580954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8508 QUEEN ELIZABETH BLVD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220034308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8508 QUEEN ELIZABETH BLVD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220034308",
            "telephone_number": "732-986-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "RUBEENA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "chicago",
            "affiliation": "Y",
            "affiliationName": "INTEGRATED REHAB CONSULTANTS LLC",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "chicago",
            "address_1": "401 N MICHIGAN AVENUE",
            "address_2": "SUITE 1200",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606114264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.