Individual provider Active NPI

Saba Tassaw

  • Family Nurse Practitioner
  • Arlington, VA
National Provider Identifier
1316631922
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187205 Issued in VA
Practice address
1701 N George Mason Dr
Arlington, VA 22205-3610
Phone
(703) 558-6371
NPI assigned
Jun 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 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 0024187205 VA Primary

Addresses

Primary practice location

1701 N George Mason Dr
Arlington, VA 22205-3610

Mailing address

1430 Deerfield LN
Woodbridge, VA 22191-1011
Phone (571) 477-9401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231201001939 VA Practitioner - Nurse Practitioner 6800244716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Regional Medical Center, PCGroup PAC ID 3577801950, 9 clinicians

Practice addresses (Care Compare)

9701 Hospital Blvd
Fredericksburg, VA 22408-7801
Phone (540) 779-0782

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024187205VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Regional Medical Center, P.C. CurrentSince Aug 31, 2024 Accepting new patients

Locations

9701 Hospital Blvd
Fredericksburg, VA 22408
Phone (540) 779-0782

8266 Atlee Rd
Ste 224
Mechanicsvlle, VA 23116
Phone (804) 454-7240

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1316631922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 DEERFIELD LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221911011",
            "telephone_number": "571-477-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GEORGE MASON DR",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053610",
            "telephone_number": "703-558-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSAW",
        "first_name": "SABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.