Individual provider Active NPI

Kylie Jane Gravatt

  • Physician Assistant
  • Washington, DC
National Provider Identifier
1417613670
Registry record updated Oct 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA200001348 Issued in DC
Practice address
3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone
(202) 444-3700
NPI assigned
Nov 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2022

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 PA200001348 DC Primary

Addresses

Primary practice location

3800 Reservoir Rd NW
Washington, DC 20007-2113

Mailing address

3800 Reservoir Rd NW
Washington, DC 20007-2113

Other practice location 1

136 Eastbury
Williamsburg, VA 23188-8908
Phone (571) 289-7273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20220317001864 DC Practitioner - Physician Assistant 8224423827 Reassigns benefits to 2 organizations
I20240711001883 VA Practitioner - Physician Assistant 8224423827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA200001348DCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince May 11, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2022 Accepting new patients
Inova Health Care Services CurrentSince May 11, 2024 Accepting new patients
Inova Health Care Services CurrentSince May 11, 2024 Accepting new patients

Locations

3800 Reservoir Rd NW
#1
Washington, DC 20007
Phone (202) 444-8612

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • Direct secure messaging: kgravatt1264911@soc.inova.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666396800000",
    "number": "1417613670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Eastbury",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231888908",
            "country_code": "US",
            "telephone_number": "571-289-7273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVATT",
        "first_name": "KYLIE",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-11",
        "last_updated": "2022-10-22",
        "certification_date": "2022-10-22",
        "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": "DC",
            "license": "PA200001348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.