Miriam Magdalena Robertson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110007354 Issued in VA

Practice address

9001 Digges Rd Ste 105
Manassas, VA 20110-4414

Phone

(703) 369-5000

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Northern Virginia Family Medicine, PC

  • Health Service Clinic/Center
  • Manassas, VA
  • NPI 1215197025
  NPD

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1407472574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N BEAUREGARD ST UNIT 628",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223114645",
            "telephone_number": "540-220-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 DIGGES RD STE 105",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104414",
            "telephone_number": "703-369-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Brixham Ct",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225547667",
            "country_code": "US",
            "telephone_number": "540-220-3594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MIRIAM",
        "middle_name": "MAGDALENA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jila Ali Rizvi
• Syed Wasi Hyder Rizvi, M.D.
• Darlene D Roberson, M.ED
• Allison Clark Humphrey Robertson, PT, DPT
• Kimberly Robertson, RBT
• Nadia Robertson, MD
• Michael B. Robins, M.D.
• Jasmine Migdalia Robinson
• Stephanie Renee Robinson, LPC
• Tiffany Robinson, RBT

• Physician Assistant in Manassas, VA
• Providers in Manassas, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.