Jackelyn R Farrell, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110003704 Issued in VA

Practice address

7600 Carroll Ave
Takoma Park, MD 20912-6367

Phone

(301) 891-5070

Fax

(301) 891-6346

NPI assigned

Oct 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jackelyn R Dutil Former name

Medicare fee-for-service enrollment

Enrolled in DC, MD, 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

Merit-based Incentive Payment System (MIPS)

Final score

95.52 of 100Reported as group

Quality

91.6

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

84.24 of 100Reported as group

Quality

75.4

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC, MD

  Medicare reassignment NPD
• Alexandria Springfield Emergency Physicians PC

  • Emergency Medicine Physician
  • Franklin, VA
  • NPI 1740529700

  DC

  Medicare reassignment NPD (past)
• Mep Health, LLC

  • Emergency Medicine Physician
  • Rockville, MD
  • NPI 1164483558

  DC

  Medicare reassignment
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061
  Medicare reassignment
• Emergency Medicine Associates PA PC

  • Emergency Medicine Physician
  • Chestertown, MD
  • NPI 1255213070
  NPD
• Inova Health Care Services

  • Diagnostic Radiology Physician
  • Waldorf, MD
  • NPI 1851829550
  NPD
• Alexandria Springfield Emergency Physicians PC

  • Emergency Medicine Physician
  • Alexandria, VA
  • NPI 1720839764
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1366727299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20010 CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741115",
            "telephone_number": "240-686-2300",
            "fax_number": "240-686-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 CARROLL AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209126367",
            "telephone_number": "301-891-5070",
            "fax_number": "301-891-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "JACKELYN",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKELYN",
            "last_name": "DUTIL",
            "middle_name": "R",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sekou Fahnbulleh
• Faith Health Care and Medical Supply
• Beryl Sandra Fani
• Marie Gaille Fankep Djomo
• Ayan Saleh Farah, M.D.
• Maren Farris, MSED BCBA
• Oluwatosin Fashola
• Fayaz a. Shawl, MD, PA
• Gary Ross Fennel, PA-C
• Kanan Dominica Lucy Fernandes, CRNP

• Medical Physician Assistant in Takoma Park, MD
• Providers in Takoma Park, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.