NPIMap

Individual provider Active NPI

Jennifer Dejesus, MD

  • Family Medicine Physician
  • Annandale, VA
National Provider Identifier
1710206818
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MAO9285100 Issued in NJ
Practice address
7611 Little River Tpke Ste 108
Annandale, VA 22003-2611
Phone
(703) 717-7215
Fax
(703) 717-7216
NPI assigned
May 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 25MAO9285100 NJ Primary

Addresses

Primary practice location

7611 Little River Tpke Ste 108
Annandale, VA 22003-2611

Mailing address

7611 Little River Tpke Ste 108
Annandale, VA 22003-2611
Phone (703) 717-7215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419000010 DC Practitioner - Family Practice 9436391638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7611 Little River Tpke
Suite 108W
Annandale, VA 22003-2611
Phone (703) 717-7215

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.33 of 100Reported as group
Quality
74.39
Promoting interoperability
87
Improvement activities
40
Cost
70.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MAO9285100NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Hospital Center Physician Group LLC CurrentSince May 16, 2022 Accepting new patients
Virginia Hospital Center Physician Group, LLC CurrentSince May 16, 2022 Accepting new patients
Virginia Hospital Center Physician Group, LLC Current Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC PastSince Aug 28, 2022 Accepting new patients
Virginia Hospital Center Physician Group LLC Past Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

7611 Little River Tpke
Ste 108W
Annandale, VA 22003
Phone (703) 658-7060

2800 S Shirlington Rd
Ste 600
Arlington, VA 22206
Phone (703) 558-8133

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

Interoperability endpoints

  • Direct secure messaging: jdejesus95166@direct.virginiahospitalcenter.net

Organizations & group practices 6

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 3

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": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1710206818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 LITTLE RIVER TPKE STE 108",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032611",
            "telephone_number": "703-717-7215",
            "fax_number": "703-717-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7611 LITTLE RIVER TPKE STE 108",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032611",
            "telephone_number": "703-717-7215",
            "fax_number": "703-717-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-28",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MAO9285100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.