Active NPI
Jessica Ann Becker, PA-C
- Physician Assistant
- Woodbridge, VA
National Provider Identifier
1699490516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110009658
- Practice address
- 13875 Hedgewood Dr Ste 210
Woodbridge, VA 22193-5922 - Phone
- (703) 434-3633
- NPI assigned
- Oct 4, 2022
- Last updated
- Apr 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2869 | NE | |
| Physician Assistant | 363A00000X | 0110009658 | VA | Primary |
Addresses
Primary practice location
13875 Hedgewood Dr Ste 210
Woodbridge, VA 22193-5922
Mailing address
6011 Archstone Way Apt 103
Alexandria, VA 22310-5515
Phone (402) 690-5916
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Nebraska College of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1982 Opitz Blvd
Woodbridge, VA 22191-3304
Phone (815) 744-8554
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712880000000",
"number": "1699490516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6011 ARCHSTONE WAY APT 103",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223105515",
"telephone_number": "402-690-5916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13875 HEDGEWOOD DR STE 210",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221935922",
"telephone_number": "703-434-3633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "JESSICA",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-04",
"last_updated": "2024-04-12",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "2869",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110009658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.