Individual provider Active NPI

Jahkia K Koomson, PA

  • Physician Assistant
  • Alexandria, VA
National Provider Identifier
1366031171
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110007517 Issued in VA
Practice address
2501 Parkers LN
Alexandria, VA 22306-3209
Phone
(703) 664-7000
NPI assigned
Jan 15, 2021
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110007517 VA Primary
Internal Medicine Physician 207R00000X 0110-007517 VA

Addresses

Primary practice location

2501 Parkers LN
Alexandria, VA 22306-3209

Mailing address

2927 Truffle Oak PL
Woodbridge, VA 22191-7519
Phone (703) 309-2972

Other practice location 1

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Other practice location 2

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

Other practice location 3

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

Other practice location 4

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

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
I20210519002424 DC Practitioner - Physician Assistant 0143629329 Reassigns benefits to 1 organization
I20220906000530 VA Practitioner - Physician Assistant 0143629329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7000

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

8503 Arlington Blvd
Fairfax, VA 22031-4628
Phone (703) 970-2670

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-007517VAMDInternal Medicine Physician
0110007517VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince May 24, 2021 Accepting new patients
Inova Health Care Services Internal Medicine CurrentSince May 24, 2021 Accepting new patients

Locations

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

8503 Arlington Blvd
Fairfax, VA 22031
Phone (703) 970-2670

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Interoperability endpoints

  • Direct secure messaging: jkoomson790991@soc.inova.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366031171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 TRUFFLE OAK PL",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221917519",
            "telephone_number": "703-309-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 PARKERS LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063209",
            "telephone_number": "703-664-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44045 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765101",
            "country_code": "US",
            "telephone_number": "703-858-6000",
            "fax_number": "703-858-6900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4320 Seminary Rd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223041535",
            "country_code": "US",
            "telephone_number": "703-504-3000",
            "fax_number": "703-504-3388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Joseph Siewick Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331709",
            "country_code": "US",
            "telephone_number": "703-391-3600",
            "fax_number": "703-391-3414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOMSON",
        "first_name": "JAHKIA",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007517",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0110-007517",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.