Individual provider Active NPI

Jessica Utech, RPA-C

  • Physician Assistant
  • Annandale, VA
National Provider Identifier
1558712802
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019764 Issued in NY
Practice address
4208 Evergreen LN Ste 213
Annandale, VA 22003-3254
Phone
(703) 642-7522
NPI assigned
Jun 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 019764 NY Primary

Addresses

Primary practice location

4208 Evergreen LN Ste 213
Annandale, VA 22003-3254

Mailing address

4208 Evergreen LN Ste 213
Annandale, VA 22003-3254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, 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
I20200320002022 CA Practitioner - Physician Assistant 1052607744 Reassigns benefits to 2 organizations
I20250721003465 DC Practitioner - Physician Assistant 1052607744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

2810 Old Lee Hwy
Suite 305
Fairfax, VA 22031-4376
Phone (703) 642-7522

7655 Leesburg Pike
Falls Church, VA 22043-2595
Phone (703) 642-7522

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Jun 12, 2020 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 10, 2025 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 10, 2025 Accepting new patients
Providence Facey Medical Foundation CurrentSince Jun 12, 2020 Accepting new patients
Dent Neuologic Institute Past Accepting new patients
Academic Medicine Services, Inc. Past Accepting new patients

Locations

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

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

4208 Evergreen Ln
Ste 213
Annandale, VA 22003

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jessica.utech.1@8042.direct.athenahealth.com
  • Direct secure messaging: jessica.utech.1@14654.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHBEAA

Organizations & group practices 7

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": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1558712802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 EVERGREEN LN STE 213",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 EVERGREEN LN STE 213",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033254",
            "telephone_number": "703-642-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTECH",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.