Individual provider Active NPI

Wasama Idlibi, PA-C

  • Physician Assistant
  • Warrenton, VA
National Provider Identifier
1689187700
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110005885 Issued in VA
Practice address
500 Hospital Dr
Warrenton, VA 20186-3027
Phone
(540) 316-5013
NPI assigned
Nov 10, 2017
Last updated
Nov 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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 0110005885 VA Primary

Addresses

Primary practice location

500 Hospital Dr
Warrenton, VA 20186-3027

Mailing address

8228 Frog Hollow CT
Manassas, VA 20111-5259
Phone (703) 582-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, 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
I20180312002299 VA Practitioner - Physician Assistant 0446512354 Reassigns benefits to 2 organizations
I20190917002520 DC Practitioner - Physician Assistant 0446512354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1701 N George Mason Dr
Arlington, VA 22205-3610
Phone (703) 558-5000

1850 Town Ctr Pkwy
Reston, VA 20190-3204
Phone (240) 686-2300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110005885VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Feb 1, 2022 Accepting new patients
Emergency Medicine Associates, PA CurrentSince Feb 1, 2022 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Feb 1, 2022 Accepting new patients
Arnot Medical Services PLLC Past Accepting new patients

Locations

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1689187700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8228 FROG HOLLOW CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201115259",
            "telephone_number": "703-582-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HOSPITAL DR",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863027",
            "telephone_number": "540-316-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDLIBI",
        "first_name": "WASAMA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, VA

Sources for this page

Verify at the official NPI Registry.