Alazar Kassa Fedlu

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110009519 Issued in VA

Practice address

2260 Stone Wheel Dr Apt E
Reston, VA 20191-3126

Phone

(571) 478-7770

NPI assigned

Nov 15, 2023

Sex

Male

Sole proprietor

No

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

State licenses

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.

• Baby Doc Inc

  dba Night Watch Pediatric Urgent Care

  • Urgent Care Clinic/Center
  • Manassas, VA
  • NPI 1174004774
  Medicare reassignment

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1508631011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 STONE WHEEL DR APT E",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913126",
            "telephone_number": "571-478-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 STONE WHEEL DR APT E",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913126",
            "telephone_number": "571-478-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Coburg Rd",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974014995",
            "country_code": "US",
            "telephone_number": "541-640-4625",
            "fax_number": "541-644-3477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDLU",
        "first_name": "ALAZAR",
        "middle_name": "KASSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-15",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009519",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA229590",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Lee Farley-Pina, M.D.
• Alyssa Muhsana Farooque, MD
• Farrell Pediatrics
• Shahrzad Fattahi, PT
• Kimberly R Faulkner, ATR-BC, LCAT
• Elizabeth D Feldman, MD
• Robin Horvitz Feldman, LCSW
• Evelyn Sylvia Felluca, MD
• Julie Thomas Feltman, PT
• Lena S Fernandes, MHS,PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.