Individual provider Active NPI

Callie Alexa Pellegrino

  • Physician Assistant
  • Purcellville, VA
National Provider Identifier
1487496816
Registry record updated Apr 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 N Maple Ave
Purcellville, VA 20132-6100
Phone
(540) 338-0032
NPI assigned
Jun 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2026

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 Primary

Addresses

Primary practice location

200 N Maple Ave
Purcellville, VA 20132-6100

Mailing address

200 N Maple Ave
Purcellville, VA 20132-6100
Phone (540) 338-0032

Other practice location 1

1775 N Sector Ct Ste 200
Winchester, VA 22601-2859
Phone (571) 442-0490

Other identifiers 1

IdentifierTypeStateIssuer
30018164800001MedicaidVA

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
I20250225003459 VA Practitioner - Physician Assistant 1153841770 Reassigns benefits to 1 organization
I20250723004848 DC Practitioner - Physician Assistant 1153841770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince Feb 18, 2025 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Loudoun Medical Group, PC CurrentSince Feb 18, 2025 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

8644 Sudley Rd
#220
Manassas, VA 20110

200 N Maple Ave
Purcellville, VA 20132
Phone (540) 338-0032

Interoperability endpoints

  • Direct secure messaging: callie.pellegrino.1@8042.direct.athenahealth.com

Organizations & group practices 4

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": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776470400000",
    "number": "1487496816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N MAPLE AVE",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326100",
            "telephone_number": "540-338-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAPLE AVE",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326100",
            "telephone_number": "540-338-0032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 N Sector Ct Ste 200",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012859",
            "country_code": "US",
            "telephone_number": "571-442-0490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLEGRINO",
        "first_name": "CALLIE",
        "middle_name": "ALEXA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-07",
        "last_updated": "2026-04-18",
        "certification_date": "2026-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30018164800001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Purcellville, VA

Sources for this page

Verify at the official NPI Registry.