Individual provider Active NPI

Jennifer B Wall, PA

  • Physician Assistant
  • Falls Church, VA
National Provider Identifier
1689699027
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110004538 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-4001
Fax
(703) 776-7113
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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 0110004538 VA Primary
Physician Assistant 363A00000X 2917 AZ

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone (602) 344-1015

Other practice location 2

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

Other practice location 3

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

Other practice location 4

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Other names 1

  • Jenn Wall Other name

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
I20150423001302 DC Practitioner - Physician Assistant 0143119263 Reassigns benefits to 2 organizations
I20190206000022 VA Practitioner - Physician Assistant 0143119263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

8503 Arlington Blvd
Fairfax, VA 22031-4628
Phone (703) 970-2670

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jan 1, 2019 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2019 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2019 Accepting new patients
Lehigh Valley Physician Group Physician Assistant Past Accepting new patients

Locations

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

8503 Arlington Blvd
Fairfax, VA 22031
Phone (703) 970-2670

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

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

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1689699027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 E Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850084948",
            "country_code": "US",
            "telephone_number": "602-344-1015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4320 Seminary Rd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223041535",
            "country_code": "US",
            "telephone_number": "703-504-3000",
            "fax_number": "703-504-3388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Joseph Siewick Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331709",
            "country_code": "US",
            "telephone_number": "703-391-3600",
            "fax_number": "703-391-3414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44045 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765101",
            "country_code": "US",
            "telephone_number": "703-858-6000",
            "fax_number": "703-858-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "JENNIFER",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004538",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENN",
            "last_name": "WALL",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.