Individual provider Active NPI

Natalee J Palacio

  • Medical Physician Assistant
  • Rockville, MD
National Provider Identifier
1336327899
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
15225 Shady Grove Rd
Ste 102
Rockville, MD 20850-3254
Phone
(301) 330-0661
Fax
(301) 977-6940
NPI assigned
Feb 7, 2008
Last updated
Feb 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X VA Primary

Addresses

Primary practice location

15225 Shady Grove Rd
Ste 102
Rockville, MD 20850-3254

Mailing address

46090 Lake Center PLZ
Ste 102
Sterling, VA 20165-5876
Phone (703) 421-1700

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
I20160316000597 VA Practitioner - Physician Assistant 0042498693 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Feb 15, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Feb 15, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

8644 Sudley Rd
#220
Manassas, VA 20110

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, 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": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1336327899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46090 LAKE CENTER PLZ",
            "address_2": "STE 102",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655876",
            "telephone_number": "703-421-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD",
            "address_2": "STE 102",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503254",
            "telephone_number": "301-330-0661",
            "fax_number": "301-977-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIO",
        "first_name": "NATALEE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.