Sydney Van Dellen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110009288 Issued in VA

Practice address

16830 Dumfries Rd
Ste 160
Dumfries, VA 22025

Phone

(703) 523-1750

Fax

(844) 518-0708

NPI assigned

Jan 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, 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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

MWHC Urgent Care LLCGroup PAC ID 8921338427, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: svandellen14406@marywashingtonhealthcare.direct-ci.com
• Direct secure messaging: svandellen16168@direct.svmh.com

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.

• MWHC Urgent Care LLC

  • Urgent Care Clinic/Center
  • King George, VA
  • NPI 1306405709
  Medicare reassignment Care Compare group
• Svmhs Clinics

  • Multi-Specialty Clinic/Center
  • Salinas, CA
  • NPI 1093158347
  Medicare reassignment NPD
• Doctors on Duty Medical Group, Inc

  • Urgent Care Clinic/Center
  • Salinas, CA
  • NPI 1568465466
  Medicare reassignment
• MWHC Urgent Care LLC

  • Urgent Care Clinic/Center
  • Stafford, VA
  • NPI 1629846951
  NPD
• Lancelot O Alexander MD a Medical Corporation

  • Specialist
  • Salinas, CA
  • NPI 1134279532
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mary Washington Hospital Inc.

  • General Acute Care Hospital
  • Fredericksburg, VA
  • NPI 1942288527
  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879

  Hospital

  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Home Health Agency
  • Fredericksburg, VA
  • NPI 1407814163

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1629669015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16830 DUMFRIES RD",
            "address_2": "STE 160",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "703-523-1750",
            "fax_number": "844-518-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16830 DUMFRIES RD",
            "address_2": "STE 160",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "703-523-1750",
            "fax_number": "844-518-0708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Lighthouse Ave",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939401439",
            "country_code": "US",
            "telephone_number": "831-649-0770",
            "fax_number": "831-649-0142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3307 Cooper St",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "285471408",
            "country_code": "US",
            "telephone_number": "262-501-8227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DELLEN",
        "first_name": "SYDNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59181",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimberly Anne Tyborowski, PT, DPT, ATC, CIDN
• Santiago Valderrama
• Vantique Payment Solution
• Teonette O Velasco, DPT
• Savithri-Chandana Veluri, VA
• Christian B Vertudes, DPT
• Vick Johns Counseling and Consulting

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.