NPIMap

Individual provider Active NPI

Diana J Ortman, PA-C

  • Physician Assistant
  • Stafford, VA
National Provider Identifier
1376645275
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002374 Issued in VA
Practice address
422 Garrisonville Rd
Suite 111
Stafford, VA 22554-1573
Phone
(540) 720-8000
Fax
(540) 657-4366
NPI assigned
Sep 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002374 VA Primary

Addresses

Primary practice location

422 Garrisonville Rd
Suite 111
Stafford, VA 22554-1573

Mailing address

PO Box 729
Garrisonville, VA 22463-0729
Phone (540) 720-0400

Other identifiers 1

IdentifierTypeStateIssuer
0110002374OtherVAVIRGINIA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070104000520 VA Practitioner - Physician Assistant 7618964115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Internal Medicine PCGroup PAC ID 3870492457, 2 clinicians

Practice addresses (Care Compare)

611 Emancipation Hwy
Suite 201
Fredericksburg, VA 22401-8402
Phone (540) 361-7390

611 Jefferson Davis Hwy 201
Fredericksburg, VA 22401-8402

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002374VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Physicians Past Accepting new patients
Colonial Beach Medical Center PastSince Mar 1, 2007 Accepting new patients
University Primary Care Practices Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ortman.diana.1@2921.direct.athenahealth.com

Organizations & group practices 5

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 5

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376645275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "GARRISONVILLE",
            "state": "VA",
            "postal_code": "224630729",
            "telephone_number": "540-720-0400",
            "fax_number": "540-657-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 GARRISONVILLE RD",
            "address_2": "SUITE 111",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541573",
            "telephone_number": "540-720-8000",
            "fax_number": "540-657-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTMAN",
        "first_name": "DIANA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA LICENSE",
            "identifier": "0110002374",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

Verify at the official NPI Registry.