Individual provider Active NPI

Gavin Tang

  • Physician Assistant
  • Reston, VA
National Provider Identifier
1407653009
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1850 Town Center Pkwy
Reston, VA 20190-3204
Phone
(703) 689-9000
NPI assigned
Mar 1, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1850 Town Center Pkwy
Reston, VA 20190-3204

Mailing address

5220 Foxon Rd
Virginia Beach, VA 23464
Phone (757) 754-0133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20251107002902 VA Practitioner - Physician Assistant 4587154406 Reassigns benefits to 1 organization
I20251118001971 DC Practitioner - Physician Assistant 4587154406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4535 Dressier Rd NW
Canton, OH 44718-2545

5220 Foxon Rd
Virginia Beach, VA 23464-7842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Sep 1, 2025 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Current Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Sep 1, 2025 Accepting new patients

Locations

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1740787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1407653009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 FOXON RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23464",
            "telephone_number": "757-754-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903204",
            "telephone_number": "703-689-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "GAVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-01",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.