Miriam Jacqueline Nicolasa Cusicanqui Monrroy, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101241806 Issued in VA

Practice address

1715 N George Mason Dr
Suite 501
Arlington, VA 22205-3609

Phone

(703) 527-4466

Fax

(703) 552-1326

NPI assigned

Jul 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ballston Family Medicine Professional name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tu Family Medical and Vision Clinic LLCGroup PAC ID 1456744473, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IECAAA

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.

• Tu Family Medical and Vision Clinic LLC

  • Primary Care Clinic/Center
  • Falls Church, VA
  • NPI 1417617465

  DC

  Medicare reassignment Care Compare group NPD
• Clinica Familiar de Arlington PC

  • Primary Care Clinic/Center
  • Arlington, VA
  • NPI 1104008820

  DC

  Medicare reassignment NPD
• Virginia Hospital Center Physician Group LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1326331976
  NPD (past)
• Wellmont Physician Services Inc

  • Internal Medicine Physician
  • Big Stone Gap, VA
  • NPI 1619095403

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1185580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1497945174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 OLD DOMINION DR",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222073527",
            "telephone_number": "703-527-4466",
            "fax_number": "703-552-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 N GEORGE MASON DR",
            "address_2": "SUITE 501",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053609",
            "telephone_number": "703-527-4466",
            "fax_number": "703-552-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSICANQUI MONRROY",
        "first_name": "MIRIAM",
        "middle_name": "JACQUELINE NICOLASA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-28",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101241806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "132601",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100033620",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497945174",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BALLSTON",
            "last_name": "MEDICINE",
            "middle_name": "FAMILY",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Curect Neuropsychology of Virginia, PLLC
• Lois Tuck Curry-Catanese, LPC
• Angela C Curry
• Davon M Curtis, PST
• Wilbert A Cusano, D.O
• Janine Michaela Cusseaux
• John A Cusumano, DDS
• Joseph J Cusumano, D.D.S.
• Michael Joseph Cusumano, DDS
• Amy Russell Cvejanovich, MSN, APRN, FNP-C

• Family Medicine Physician in Arlington, VA
• Providers in Arlington, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.