Individual provider Active NPI

Tara C Villano, PA

  • Physician Assistant
  • Sterling, VA
National Provider Identifier
1619968906
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002514 Issued in VA
Practice address
47100 Community PLZ
Sterling, VA 20164-1826
Phone
(703) 880-1403
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA030369 DC
Physician Assistant 363A00000X 0110002514 VA Primary

Addresses

Primary practice location

47100 Community PLZ
Sterling, VA 20164-1826

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 965-8700

Other identifiers 2

IdentifierTypeStateIssuer
005814995MedicaidVA
110184642OtherDCRAILROAD PALMETTO MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirst.com Health Information Exchange (HIE)

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
I20050512000141 DC Practitioner - Physician Assistant 4880634542 Reassigns benefits to 1 organization
I20120327000839 VA Practitioner - Physician Assistant 4880634542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2199 Old Bridge Rd
Woodbridge, VA 22192-2911
Phone (703) 357-9707

3031 Plank Rd
Fredericksburg, VA 22401-4951
Phone (540) 736-5043

47100 Community PLZ
Suite 100
Sterling, VA 20164-1821
Phone (703) 880-1403

601 Potomac Station Dr
Leesburg, VA 20176-1816
Phone (703) 840-1396

6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087

9715 Liberia Ave
Manassas, VA 20110-5837
Phone (571) 229-1797

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA030369DCMDPhysician Assistant
0110002514VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC CurrentSince Jan 13, 2012 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Jan 13, 2012 Accepting new patients
Washington Metropolitan Practice Plan Physician Assistant Past Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

5000 Cox Rd
Ste 100
Glen Allen, VA 23060
Phone (804) 822-4383

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

47100 Community Plz
Sterling, VA 20164
Phone (703) 433-2730

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1619968906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-965-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47100 COMMUNITY PLZ",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201641826",
            "telephone_number": "703-880-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANO",
        "first_name": "TARA",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030369",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005814995",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PALMETTO MEDICARE",
            "identifier": "110184642",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirst.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "47100 Community Plz",
            "city": "Sterling",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201641826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

Verify at the official NPI Registry.