Marisa Wong, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024177055 Issued in VA

Practice address

2710 Prosperity Ave Ste 200
Fairfax, VA 22031-4358

Phone

(703) 280-2841

NPI assigned

Jul 26, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marisa.wong@tysons.ikm.direct-ci.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.

• Fairfax Colon & Rectal Surgery, PC

  • Specialist
  • Fairfax, VA
  • NPI 1427169507

  DC

  Medicare reassignment NPD
• Hematology Oncology of Tysons PLLC

  • Oncology Clinic/Center
  • Vienna, VA
  • NPI 1386027019
  NPD

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1649906454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8525 TYSONS CT",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221825019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 PROSPERITY AVE STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314358",
            "telephone_number": "703-280-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MARISA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Women'S Choice OBGYN LLC
• Womens Health Associates P.C.
• Jemoon Won
• Alissa Levine Wong, DNP, FNP-C
• Derek Wong, FNP-C
• Mayin Wong, DO
• Randall Vernon Wong, M.D.
• Andrew Woo, M.D.
• Molly Wood, MSN, FNP-BC
• Nicole Michelle Woodard, PSY.D.

• Family Nurse Practitioner in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.