Kevin Joseph Maneffa, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110-008478 Issued in VA

Practice address

6355 Walker LN Ste 401
Alexandria, VA 22310-3250

Phone

(703) 924-2100

NPI assigned

Jul 2, 2021

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Pediatric Associates of Alexandria

  • Pediatrics Physician
  • Alexandria, VA
  • NPI 1447358486
  NPD (past)

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1669043469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N NASH ST APT 232",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222093626",
            "telephone_number": "858-888-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN STE 401",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103250",
            "telephone_number": "703-924-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEFFA",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-02",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008019",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-008478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Mira Manalastas, LPC-R, ATR-P
• Rajana Manandhar
• Manchester Lakes Medical
• Lauren Mancinelli, OD
• Rufaat Mando
• Kaitlyn Mangan
• Teagan Mangan
• Marie T. Mangin, PSY.D.
• Jessica Mangskau, MA
• Shanell L Manibusan, COTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.