Individual provider Active NPI

David Alan Kon, PA-C

  • Physician Assistant
  • Alexandria, VA
National Provider Identifier
1407040454
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001993 Issued in VA
Practice address
4660 Kenmore Ave Ste 1000
Alexandria, VA 22304-1300
Phone
(703) 370-0010
Fax
(703) 370-2002
NPI assigned
Sep 4, 2007
Last updated
Sep 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 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 0110001993 VA Primary

Addresses

Primary practice location

4660 Kenmore Ave Ste 1000
Alexandria, VA 22304-1300

Mailing address

4660 Kenmore Ave Ste 1000
Alexandria, VA 22304-1300
Phone (703) 370-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20110901000399 DC Practitioner - Physician Assistant 1456521343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Virginia IncGroup PAC ID 9436438538, 27 clinicians

Practice addresses (Care Compare)

3700 Joseph Siewick Dr
Suite 302
Fairfax, VA 22033-1739
Phone (703) 648-2488

Merit-based Incentive Payment System (MIPS)

Final score
75.95 of 100Reported as group
Quality
78.27
Promoting interoperability
91
Improvement activities
20
Cost
74.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110001993VAMDPhysician Assistant

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, 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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1407040454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 1000",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041300",
            "telephone_number": "703-370-0010",
            "fax_number": "703-370-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 1000",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041300",
            "telephone_number": "703-370-0010",
            "fax_number": "703-370-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KON",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.